title: Clinicopathological study on the intraductal spread of small pancreatic cancer.
abstract: BACKGROUND
  The aim of this study was to evaluate histopathologically the frequency, direction, and length of intraductal spread (IS) along the main pancreatic duct from the main tumor of small pancreatic cancer.
  
  
  METHODS
  Resected specimens from 20 cases of pTS1 (histologically 2 cm or less in diameter) pancreatic cancer (September 1983 to December 2005) were examined histopathologically. As controls, 40 resected specimens from cases of pTS2 (more than 2 cm and less than 4 cm in diameter) or larger sized pancreatic cancer (pTS2<or=) were examined in the same manner. The specimens were evaluated histopathologically as to (1) the prevalence of IS, (2) the direction and length of IS, and (3) the positive rates of transpapillary cytology of pure pancreatic juice (TPC) and biopsy of the main pancreatic duct (TPB), performed preoperatively.
  
  
  RESULTS
  IS was observed in 45% of pTS1 and 13% of pTS2<or= cases. In 88% of cases of pTS1, IS was observed in the direction of the ampullary side. In 40% of cases of pTS2<or=, IS toward the ampullary side was seen. The mean length of IS in pTS1 and pTS2<or= cases was 11.8 mm and 7.2 mm, respectively. Positive rates of TPC and TPB in pTS1 cases were 70% and 75%, respectively, and in pTS2<or= cases, 50% and 44%, respectively.
  
  
  CONCLUSIONS
  The frequency of IS was high in pTS1 cases, which suggests there is potential for improvement in establishing the histocytological diagnosis of small pancreatic cancer via the transpapillary approach with the development of adequate tools.
authors: Department of Gastroenterology, Sendai City Medical Center, 5-22-1 Tsurugaya, Miyagino-ku, Sendai 983-0824, Japan.
authors: Osamu
authors: O
authors: Takasawa
authors: Naotaka
authors: N
authors: Fujita
authors: Yutaka
authors: Y
authors: Noda
authors: Go
authors: G
authors: Kobayashi
authors: Kei
authors: K
authors: Ito
authors: Jun
authors: J
authors: Horaguchi
authors: Takashi
authors: T
authors: Obana
authors: Takuro
authors: T
authors: Endo
authors: Kazunari
authors: K
authors: Nakahara
authors: Kazuhiko
authors: K
authors: Ishida
authors: Shigeharu
authors: S
authors: Seno
authors: Makoto
authors: M
authors: Yonechi
authors: Takashi
authors: T
authors: Suzuki
authors: Dai
authors: D
authors: Hirasawa
authors: Toshiki
authors: T
authors: Sugawara
authors: Tetsuya
authors: T
authors: Ohira
authors: Kengo
authors: K
authors: Onochi
authors: Yoshihiro
authors: Y
authors: Harada
authors: Hiroyuki
authors: H
authors: Unakami
authors: Takashi
authors: T
authors: Sawai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology* / Q000503:physiopathology / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology; D010183:Pancreatic Ducts / Q000473:pathology; D010189:Pancreatic Juice / Q000166:cytology; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000556:secondary*