Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Pancreatic duct lavage cytology combined with a cell-block method for patients with possible pancreatic ductal adenocarcinomas, including pancreatic carcinoma in situ

  • Hiroaki Kusunose (Department of Gastroenterology, Sendai City Medical Center) ;
  • Shinsuke Koshita (Department of Gastroenterology, Sendai City Medical Center) ;
  • Yoshihide Kanno (Department of Gastroenterology, Sendai City Medical Center) ;
  • Takahisa Ogawa (Department of Gastroenterology, Sendai City Medical Center) ;
  • Toshitaka Sakai (Department of Gastroenterology, Sendai City Medical Center) ;
  • Keisuke Yonamine (Department of Gastroenterology, Sendai City Medical Center) ;
  • Kazuaki Miyamoto (Department of Gastroenterology, Sendai City Medical Center) ;
  • Fumisato Kozakai (Department of Gastroenterology, Sendai City Medical Center) ;
  • Hideyuki Anan (Department of Gastroenterology, Sendai City Medical Center) ;
  • Kazuki Endo (Department of Gastroenterology, Sendai City Medical Center) ;
  • Haruka Okano (Department of Gastroenterology, Sendai City Medical Center) ;
  • Masaya Oikawa (Department of Surgery, Sendai City Medical Center) ;
  • Takashi Tsuchiya (Department of Surgery, Sendai City Medical Center) ;
  • Takashi Sawai (Department of Pathology, Sendai City Medical Center) ;
  • Yutaka Noda (Department of Gastroenterology, Sendai City Medical Center) ;
  • Kei Ito (Department of Gastroenterology, Sendai City Medical Center)
  • Received : 2021.12.08
  • Accepted : 2022.04.04
  • Published : 2023.05.30
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Abstract

Background/Aims: This study aimed to clarify the efficacy and safety of pancreatic duct lavage cytology combined with a cell-block method (PLC-CB) for possible pancreatic ductal adenocarcinomas (PDACs). Methods: This study included 41 patients with suspected PDACs who underwent PLC-CB mainly because they were unfit for undergoing endoscopic ultrasonography-guided fine needle aspiration. A 6-Fr double lumen catheter was mainly used to perform PLC-CB. Final diagnoses were obtained from the findings of resected specimens or clinical outcomes during surveillance after PLC-CB. Results: Histocytological evaluations using PLC-CB were performed in 87.8% (36/41) of the patients. For 31 of the 36 patients, final diagnoses (invasive PDAC, 12; pancreatic carcinoma in situ, 5; benignancy, 14) were made, and the remaining five patients were excluded due to lack of surveillance periods after PLC-CB. For 31 patients, the sensitivity, specificity, and accuracy of PLC-CB for detecting malignancy were 94.1%, 100%, and 96.8%, respectively. In addition, they were 87.5%, 100%, and 94.1%, respectively, in 17 patients without pancreatic masses detectable using endoscopic ultrasonography. Four patients developed postprocedural pancreatitis, which improved with conservative therapy. Conclusions: PLC-CB has an excellent ability to detect malignancies in patients with possible PDACs, including pancreatic carcinoma in situ.

Keywords

Acknowledgement

We would like to thank Fumiyoshi Fujishima, MD, PhD, Department of Pathology, Tohoku University School of Medicine, Miwa Uzuki, MD, PhD, Department of Nursing, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, and Toru Furukawa, MD, PhD, Department of Investigative Pathology, Tohoku University Graduate School of Medicine for histocylogical evaluations using cytological specimens and resected specimens from all subjects, and all staff in the Department of Pathology at Sendai City Medical Center for performing immunohistochemical staining in this study. In addition, we are grateful to Dr. Brian Breedlove, Associate Professor, Tohoku University School of Science, for English proofreading.

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