title: Diagnostic strategies for early pancreatic cancer.
abstract: Diagnosis of pancreatic cancer (PC) at an early stage with curative surgery is the approach with the potential to significantly improve long-term patient outcome. Recently, some reports showed that patients with pancreatic tumors smaller than 10 mm showed a favorable prognosis. However, the rate of tumor detection on computed tomography in patients with small pancreatic tumors is low. For the diagnoses of PC with tumors smaller than 10 mm, the rate of tumor detection was higher on endoscopic ultrasonography (EUS) than on computed tomography or other modalities, and histologic diagnosis using EUS-guided fine-needle aspiration was helpful in confirming the diagnosis. For the diagnosis of PC in situ, EUS and magnetic resonance cholangiopancreatography may play important roles in detecting the local irregular stenosis of the pancreatic duct. Endoscopic retrograde pancreatography and sequential cytodiagnosis using pancreatic juice obtained by endoscopic nasopancreatic drainage multiple times was useful in the final diagnosis of PC in situ. At present, improving survival lies in identifying those individuals with high-risk factors or precursor lesions through an effective screening method. For example, these should include ultrasonography, various biological markers, or national familial pancreatic cancer registration. Additionally, the relationship between specialists in PC from medical centers and practicing physicians plays an important role in the early diagnosis of PC.
authors.affiliation: Department of Gastroenterology, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, 722-8508, Japan, kh-ajpbd@nifty.com.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hanada
authors.forename: Akihito
authors.initials: A
authors.lastname: Okazaki
authors.forename: Naomichi
authors.initials: N
authors.lastname: Hirano
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Izumi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Teraoka
authors.forename: Juri
authors.initials: J
authors.lastname: Ikemoto
authors.forename: Kozue
authors.initials: K
authors.lastname: Kanemitsu
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Hino
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Fukuda
authors.forename: Shuji
authors.initials: S
authors.lastname: Yonehara
mesh_terms: D002278:Carcinoma in Situ / Q000175:diagnosis; D055088:Early Detection of Cancer / Q000379:methods; D042241:Early Diagnosis; D019160:Endosonography / Q000379:methods; D006801:Humans; D007400:Interprofessional Relations; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D012307:Risk Factors