- The Second Hospital of Lanzhou University, Gansu Province Key Laboratory of Digestive Tumors, Lanzhou 730030, ChinaCorresponding Author: LI Yu-min, E-mail: lym19621225@hotmail.com;
Objective To summarize the progress of endoscopic diagnosis and therapy for pancreatic cancer.
Methods Domestic and international publications online involving progress of diagnosis and therapy for pancreatic cancer by using endoscope in recent years were collected and reviewed.
Results Recently, early diagnostic rate of pancreatic cancer increased with the development of endoscope and endoscopic technique such as endoscopic ultrasound, endoscopic ultrasound-guided fine needle aspiration, peroral pancreatoscopy, optical coherence tomography, ERCP, and cytology in pancreatic juice. Furthermore, varied therapies such as endoscopic ultrasound guided celiac plexus neurolysis, implantation of iodine 125-particles or pancreatic duct/bile duct stents were performed by endoscope for advanced pancreatic cancer.
Conclusion Early diagnostic rate and novel therapeutic alternative of pancreatic cancer are supplied by digestive endoscopy.
Citation： ZHANG Dekui,LI Yumin.. Progress of Endoscopic Diagnosis and Therapy for Pancreatic Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(10): 1027-1031. doi: Copy
| 1. | Murray D, Price R. What the endoscopist saw [J]. Br J Radiol, 2001; 74(887): 1074-1075. |
| 2. | Soriano A, Castells A, Ayuso C, et al. Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography [J]. Am J Gastroenterol, 2004; 99(3): 492-501. |
| 3. | Furukawa T, Tsukamoto Y, Naitoh Y, et al. Evaluation of intraductal ultrasonography in the diagnosis of pancreatic cancer [J]. Endoscopy, 1993; 25(9): 577-581. |
| 4. | 金震东, 蔡振寨, 李兆申, 等. 内镜超声检查术对胰腺肿瘤早期诊断的价值 [J]. 中华内科杂志, 2007； 46（12）： 984-987. |
| 5. | Maguchi H. The roles of endoscopic ultrasonography in the diagnosis of pancreatic tumors [J]. J Hepatobiliary Pancreat Surg, 2004; 11(1): 1-3. |
| 6. | Habr F, Akerman P. Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer [J]. Front Biosci, 2000; 5: E30-E35. |
| 7. | Fujita N, Noda Y, Kobayashi G, et al. Endoscopic approach to early diagnosis of pancreatic cancer [J]. Pancreas, 2004; 28(3): 279-281. |
| 8. | 韦璐, 令狐恩强, 杨云生, 等. 内镜下逆行胰胆管造影结合胰胆管腔内超声对胰腺癌诊断价值的研究 [J]. 中国实用内科杂志, 2008; 28(3): 197-199. |
| 9. | Iglesias-Garcia J, Larino-Noia J, Abdulkader I, et al. Quantitative endoscopic ultrasound elastography: An accurate method for the differentiation of solid pancreatic masses [J]. Gastroenterology, 2010 Jun 27. [Epub ahead of print]. |
| 10. | Kliment M, Urban O, Cegan M, et al. Endoscopic ultrasound-guided fine needle aspiration of pancreatic masses: the utility and impact on management of patients [J]. Scand J Gastroenterol, 2010 Jul 14. [Epub ahead of print]. |
| 11. | McCune WS, Shorb PE, Moscovitz H. Endoscopic cannulation of the ampulla of Vater: a preliminary report [J]. Ann Surg, 1968; 167(5): 752-756. |
| 12. | Shimizu S, Kutsumi H, Fujimoto S, et al. Diagnostic endoscopic retrograde cholangiopancreatography [J]. Endoscopy, 1998; 30(2): 158-162. |
| 13. | 王志勇, 马世华, 李志娟. 经内镜逆行胰胆管造影诊治胰胆疾病610例分析 [J]. 中国实用内科杂志, 2005; 25(8): 738-739. |
| 14. | Namieno T, Koito K, Nagakawa T, et al. Diagnostic features on images in primary small cell carcinoma of the pancreas [J]. Am J Gastroenterol, 1997; 92(2): 319-322. |
| 15. | Nakaizumi A, Tatsuta M, Uehara H, et al. Cytologic examination of pure pancreatic juice in the diagnosis of pancreatic carcinoma. The endoscopic retrograde intraductal catheter aspiration cytologic technique [J]. Cancer, 1992; 70(11): 2610-2614. |
| 16. | 周国雄, 黄介飞, 张弘, 等. 内镜下胰液收集及肿瘤标记物检测对胰腺癌的诊断价值 [J]. 临床内科杂志, 2005; 26(6): 397-399. |
| 17. | 刘枫, 李兆申, 许国铭. 胰液中肿瘤标志物的检测在胰腺癌诊断中的价值 [J]. 胃肠病学, 2000; 5(4): 248-250. |
| 18. | Nakaizumi A, Uehara H, Takenaka A, et al. Diagnosis of pancreatic cancer by cytology and measurement of oncogene and tumor markers in pure pancreatic juice aspirated by endoscopy [J]. Hepatogastroenterology, 1999; 46(25): 31-37. |
| 19. | Chen R, Pan S, Duan X, et al. Elevated level of anterior gradient-2 in pancreatic juice from patients with pre-malignant pancreatic neoplasia [J]. Mol Cancer, 2010; 9: 149-160. |
| 20. | Nakashima A, Murakami Y, Uemura K, et al. Usefulness of human telomerase reverse transcriptase in pancreatic juice as a biomarker of pancreatic malignancy [J]. Pancreas, 2009; 38(5): 527-533. |
| 21. | Habbe N, Koorstra JB, Mendell JT, et al. MicroRNA miR-155 is a biomarker of early pancreatic neoplasia [J]. Cancer Biol Ther, 2009; 8(4): 340-346. |
| 22. | Sitek B, Sipos B, Alkatout I, et al. Analysis of the pancreatic tumor progression by a quantitative proteomic approach and immunhistochemical validation [J]. J Proteome Res, 2009; 8(4): 1647-1656. |
| 23. | Shirai Y, Sogawa K, Yamaguchi T, et al. Protein profiling in pancreatic juice for detection of intraductal papillary mucinous neoplasm of the pancreas [J]. Hepatogastroenterology, 2008; 55(86-87): 1824-1829. |
| 24. | Jiang P, Watanabe H, Okada G, et al. Diagnostic utility of aberrant methylation of tissue factor pathway inhibitor 2 in pure pancreatic juice for pancreatic carcinoma [J]. Cancer Sci, 2006; 97(11): 1267-1273. |
| 25. | Watanabe H, Okada G, Ohtsubo K, et al. Aberrant methylation of secreted apoptosis-related protein 2 (SARP2) in pure pancreatic juice in diagnosis of pancreatic neoplasms [J]. Pancreas, 2006; 32(4): 382-389. |
| 26. | Sai JK, Suyama M, Kubokawa Y, et al. Pancreatic duct lavage cytology for the diagnosis of branch duct-type intraductalpapillary mucinous neoplasm of the pancreas [J]. Pancreas, 2008; 36(2): 216-217. |
| 27. | Yasuda K, Sakata M, Ueda M, et al. The use of pancreatoscopy in the diagnosis of intraductal papillary mucinous tumor lesions of the pancreas [J]. Clin Gastroenterol Hepatol, 2005; 3(7 Suppl 1): S53-S57. |
| 28. | Chen YK. Pancreatoscopy: present and future role [J]. Curr Gastroenterol Rep, 2007; 9(2): 136-143. |
| 29. | Ringold DA, Shah RJ. Peroral pancreatoscopy in the diagnosis and management of intraductal papillarymucinous neoplasia and indeterminate pancreatic duct pathology [J]. Gastrointest Endosc Clin N Am, 2009; 19(4): 601-613. |
| 30. | Murashima Y, Suga T, Koito K, et al. Peroral endoscopical diagnosis for the early stage of cancer in bilio-pancreatic system [J]. Rinsho Byori, 1990; 38(3): 231-239. |
| 31. | Testoni PA, Mangiavillano B. Optical coherence tomography in detection of dysplasia and cancer of the gastrointestinal tract and bilio-pancreatic ductal system [J]. World J Gastroenterol, 2008; 14(42): 6444-6452. |
| 32. | Testoni PA, Mangiavillano B, Albarello L, et al. Optical coherence tomography to detect epithelial lesions of the main pancreatic duct: an Ex Vivo study [J]. Am J Gastroenterol, 2005; 100(12): 2777-2783. |
| 33. | Tham TC, Lichtenstein DR, Vandervoort J, et al. Pancreatic duct stents for “obstructive type” pain in pancreatic malignancy [J]. Am J Gastroenterol, 2000; 95(4): 956-960. |
| 34. | Harada R, Kawamoto H, Fukatsu H, et al. Nonprevention of post-endoscopic retrograde cholangiopancreatographic pancreatitis by pancreatic stent after aspiration of pure pancreatic juice in patients with intraductal papillary mucinous neoplasms of the pancreas [J]. Pancreas, 2010; 39(3): 340-344. |
| 35. | Nguyen-Tang T, Binmoeller KF, Sanchez-Yague A, et al. Endoscopic ultrasound (EUS)-guided transhepatic anterograde self-expandable metal stent (SEMS) placement across malignant biliary obstruction [J]. Endoscopy, 2010; 42(3): 232-236. |
| 36. | Mezhir JJ, Brennan MF, Baser RE, et al. A matched case-control study of preoperative biliary drainage in patients with pancreatic adenocarcinoma: routine drainage is not justified [J]. J Gastrointest Surg, 2009; 13(12): 2163-2169. |
| 37. | Strecker EP, Hagen B, Liermann D, et al. Current status of the Strecker stent [J]. Cardiol Clin, 1994; 12(4): 673-687. |
| 38. | Espinel J, Vivas S, Muoz F, et al. Palliative treatment of malignant obstruction of gastric outlet using an endoscopically placed enteral wallstent [J]. Dig Dis Sci, 2001; 46(11): 2322-2324. |
| 39. | Holm HH, Stryer I, Hansen H, et al. Ultrasonically guided percutaneous interstitial implantation of iodine 125 seeds in cancer therapy [J]. Br J Radiol, 1981; 54(644): 665-670. |
| 40. | Peretz T, Nori D, Hilaris B, et al. Treatment of primary unresectable carcinoma of the pancreas with I-125 implantation [J]. Int J Radiat Oncol Biol Phys, 1989; 17(5): 931-935. |
| 41. | 王俊杰, 黄毅, 冉维强, 等. 放射性粒子组织间种植治疗肿瘤近期疗效 [J]. 中国微创外科杂志, 2003; 3(2): 148-149. |
| 42. | 金震东, 李兆申, 刘岩, 等. 超声内镜引导下定向植入放射性125I粒子治疗胰腺癌的临床研究 [J]. 中国消化内镜杂志, 2006; 23(1): 15-18. |
| 43. | Jin Z, Du Y, Li Z, et al. Endoscopic ultrasonography-guided interstitial implantation of iodine 125-seeds combined with chemotherapy in the treatment of unresectable pancreatic carcinoma: a prospective pilot study [J]. Endoscopy, 2008; 40(4): 314-320. |
| 44. | Liu Y, Lu Z, Zou DW, et al. Intraluminal implantation of radioactive stents for treatment of primary carcinomas of the peripancreatic-head region: a pilot study [J]. Gastrointest Endosc, 2009; 69(6): 1067-1073. |
| 45. | Nori D, Merimsky O, Osian AD, et al. Palladium-103: a new radioactive source in the treatment of unresectable carcinoma of the pancreas: a phase Ⅰ-Ⅱ study [J]. J Surg Oncol, 1996; 61(4): 300-305. |
| 46. | De Oliveira R, dos Reis MP, Prado WA. The effects of early or late neurolytic sympathetic plexus block on the management of abdominal or pelvic cancer pain [J]. Pain, 2004； 110（1-2）: 400-408. |
| 47. | Caraceni A, Portenoy RK. Pain management in patients with pancreatic carcinoma [J]. Cancer, 1996； 78(Suppl 3): 639-653. |
| 48. | Wiersema MJ, Wiersema LM. Endosonography-guided celiac plexus neurolysis [J]. Gastrointest Endosc, 1996; 44(6): 656-662. |
| 49. | Gunaratnam NT, Sarma AV, Norton ID, et al. A prospective study of EUS-guided celiac plexus neurolysis for pancreatic cancer pain [J]. Gastrointest Endosc, 2001; 54(3): 316-324. |
- 1. Murray D, Price R. What the endoscopist saw [J]. Br J Radiol, 2001; 74(887): 1074-1075.
- 2. Soriano A, Castells A, Ayuso C, et al. Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography [J]. Am J Gastroenterol, 2004; 99(3): 492-501.
- 3. Furukawa T, Tsukamoto Y, Naitoh Y, et al. Evaluation of intraductal ultrasonography in the diagnosis of pancreatic cancer [J]. Endoscopy, 1993; 25(9): 577-581.
- 4. 金震东, 蔡振寨, 李兆申, 等. 内镜超声检查术对胰腺肿瘤早期诊断的价值 [J]. 中华内科杂志, 2007； 46（12）： 984-987.
- 5. Maguchi H. The roles of endoscopic ultrasonography in the diagnosis of pancreatic tumors [J]. J Hepatobiliary Pancreat Surg, 2004; 11(1): 1-3.
- 6. Habr F, Akerman P. Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer [J]. Front Biosci, 2000; 5: E30-E35.
- 7. Fujita N, Noda Y, Kobayashi G, et al. Endoscopic approach to early diagnosis of pancreatic cancer [J]. Pancreas, 2004; 28(3): 279-281.
- 8. 韦璐, 令狐恩强, 杨云生, 等. 内镜下逆行胰胆管造影结合胰胆管腔内超声对胰腺癌诊断价值的研究 [J]. 中国实用内科杂志, 2008; 28(3): 197-199.
- 9. Iglesias-Garcia J, Larino-Noia J, Abdulkader I, et al. Quantitative endoscopic ultrasound elastography: An accurate method for the differentiation of solid pancreatic masses [J]. Gastroenterology, 2010 Jun 27. [Epub ahead of print].
- 10. Kliment M, Urban O, Cegan M, et al. Endoscopic ultrasound-guided fine needle aspiration of pancreatic masses: the utility and impact on management of patients [J]. Scand J Gastroenterol, 2010 Jul 14. [Epub ahead of print].
- 11. McCune WS, Shorb PE, Moscovitz H. Endoscopic cannulation of the ampulla of Vater: a preliminary report [J]. Ann Surg, 1968; 167(5): 752-756.
- 12. Shimizu S, Kutsumi H, Fujimoto S, et al. Diagnostic endoscopic retrograde cholangiopancreatography [J]. Endoscopy, 1998; 30(2): 158-162.
- 13. 王志勇, 马世华, 李志娟. 经内镜逆行胰胆管造影诊治胰胆疾病610例分析 [J]. 中国实用内科杂志, 2005; 25(8): 738-739.
- 14. Namieno T, Koito K, Nagakawa T, et al. Diagnostic features on images in primary small cell carcinoma of the pancreas [J]. Am J Gastroenterol, 1997; 92(2): 319-322.
- 15. Nakaizumi A, Tatsuta M, Uehara H, et al. Cytologic examination of pure pancreatic juice in the diagnosis of pancreatic carcinoma. The endoscopic retrograde intraductal catheter aspiration cytologic technique [J]. Cancer, 1992; 70(11): 2610-2614.
- 16. 周国雄, 黄介飞, 张弘, 等. 内镜下胰液收集及肿瘤标记物检测对胰腺癌的诊断价值 [J]. 临床内科杂志, 2005; 26(6): 397-399.
- 17. 刘枫, 李兆申, 许国铭. 胰液中肿瘤标志物的检测在胰腺癌诊断中的价值 [J]. 胃肠病学, 2000; 5(4): 248-250.
- 18. Nakaizumi A, Uehara H, Takenaka A, et al. Diagnosis of pancreatic cancer by cytology and measurement of oncogene and tumor markers in pure pancreatic juice aspirated by endoscopy [J]. Hepatogastroenterology, 1999; 46(25): 31-37.
- 19. Chen R, Pan S, Duan X, et al. Elevated level of anterior gradient-2 in pancreatic juice from patients with pre-malignant pancreatic neoplasia [J]. Mol Cancer, 2010; 9: 149-160.
- 20. Nakashima A, Murakami Y, Uemura K, et al. Usefulness of human telomerase reverse transcriptase in pancreatic juice as a biomarker of pancreatic malignancy [J]. Pancreas, 2009; 38(5): 527-533.
- 21. Habbe N, Koorstra JB, Mendell JT, et al. MicroRNA miR-155 is a biomarker of early pancreatic neoplasia [J]. Cancer Biol Ther, 2009; 8(4): 340-346.
- 22. Sitek B, Sipos B, Alkatout I, et al. Analysis of the pancreatic tumor progression by a quantitative proteomic approach and immunhistochemical validation [J]. J Proteome Res, 2009; 8(4): 1647-1656.
- 23. Shirai Y, Sogawa K, Yamaguchi T, et al. Protein profiling in pancreatic juice for detection of intraductal papillary mucinous neoplasm of the pancreas [J]. Hepatogastroenterology, 2008; 55(86-87): 1824-1829.
- 24. Jiang P, Watanabe H, Okada G, et al. Diagnostic utility of aberrant methylation of tissue factor pathway inhibitor 2 in pure pancreatic juice for pancreatic carcinoma [J]. Cancer Sci, 2006; 97(11): 1267-1273.
- 25. Watanabe H, Okada G, Ohtsubo K, et al. Aberrant methylation of secreted apoptosis-related protein 2 (SARP2) in pure pancreatic juice in diagnosis of pancreatic neoplasms [J]. Pancreas, 2006; 32(4): 382-389.
- 26. Sai JK, Suyama M, Kubokawa Y, et al. Pancreatic duct lavage cytology for the diagnosis of branch duct-type intraductalpapillary mucinous neoplasm of the pancreas [J]. Pancreas, 2008; 36(2): 216-217.
- 27. Yasuda K, Sakata M, Ueda M, et al. The use of pancreatoscopy in the diagnosis of intraductal papillary mucinous tumor lesions of the pancreas [J]. Clin Gastroenterol Hepatol, 2005; 3(7 Suppl 1): S53-S57.
- 28. Chen YK. Pancreatoscopy: present and future role [J]. Curr Gastroenterol Rep, 2007; 9(2): 136-143.
- 29. Ringold DA, Shah RJ. Peroral pancreatoscopy in the diagnosis and management of intraductal papillarymucinous neoplasia and indeterminate pancreatic duct pathology [J]. Gastrointest Endosc Clin N Am, 2009; 19(4): 601-613.
- 30. Murashima Y, Suga T, Koito K, et al. Peroral endoscopical diagnosis for the early stage of cancer in bilio-pancreatic system [J]. Rinsho Byori, 1990; 38(3): 231-239.
- 31. Testoni PA, Mangiavillano B. Optical coherence tomography in detection of dysplasia and cancer of the gastrointestinal tract and bilio-pancreatic ductal system [J]. World J Gastroenterol, 2008; 14(42): 6444-6452.
- 32. Testoni PA, Mangiavillano B, Albarello L, et al. Optical coherence tomography to detect epithelial lesions of the main pancreatic duct: an Ex Vivo study [J]. Am J Gastroenterol, 2005; 100(12): 2777-2783.
- 33. Tham TC, Lichtenstein DR, Vandervoort J, et al. Pancreatic duct stents for “obstructive type” pain in pancreatic malignancy [J]. Am J Gastroenterol, 2000; 95(4): 956-960.
- 34. Harada R, Kawamoto H, Fukatsu H, et al. Nonprevention of post-endoscopic retrograde cholangiopancreatographic pancreatitis by pancreatic stent after aspiration of pure pancreatic juice in patients with intraductal papillary mucinous neoplasms of the pancreas [J]. Pancreas, 2010; 39(3): 340-344.
- 35. Nguyen-Tang T, Binmoeller KF, Sanchez-Yague A, et al. Endoscopic ultrasound (EUS)-guided transhepatic anterograde self-expandable metal stent (SEMS) placement across malignant biliary obstruction [J]. Endoscopy, 2010; 42(3): 232-236.
- 36. Mezhir JJ, Brennan MF, Baser RE, et al. A matched case-control study of preoperative biliary drainage in patients with pancreatic adenocarcinoma: routine drainage is not justified [J]. J Gastrointest Surg, 2009; 13(12): 2163-2169.
- 37. Strecker EP, Hagen B, Liermann D, et al. Current status of the Strecker stent [J]. Cardiol Clin, 1994; 12(4): 673-687.
- 38. Espinel J, Vivas S, Muoz F, et al. Palliative treatment of malignant obstruction of gastric outlet using an endoscopically placed enteral wallstent [J]. Dig Dis Sci, 2001; 46(11): 2322-2324.
- 39. Holm HH, Stryer I, Hansen H, et al. Ultrasonically guided percutaneous interstitial implantation of iodine 125 seeds in cancer therapy [J]. Br J Radiol, 1981; 54(644): 665-670.
- 40. Peretz T, Nori D, Hilaris B, et al. Treatment of primary unresectable carcinoma of the pancreas with I-125 implantation [J]. Int J Radiat Oncol Biol Phys, 1989; 17(5): 931-935.
- 41. 王俊杰, 黄毅, 冉维强, 等. 放射性粒子组织间种植治疗肿瘤近期疗效 [J]. 中国微创外科杂志, 2003; 3(2): 148-149.
- 42. 金震东, 李兆申, 刘岩, 等. 超声内镜引导下定向植入放射性125I粒子治疗胰腺癌的临床研究 [J]. 中国消化内镜杂志, 2006; 23(1): 15-18.
- 43. Jin Z, Du Y, Li Z, et al. Endoscopic ultrasonography-guided interstitial implantation of iodine 125-seeds combined with chemotherapy in the treatment of unresectable pancreatic carcinoma: a prospective pilot study [J]. Endoscopy, 2008; 40(4): 314-320.
- 44. Liu Y, Lu Z, Zou DW, et al. Intraluminal implantation of radioactive stents for treatment of primary carcinomas of the peripancreatic-head region: a pilot study [J]. Gastrointest Endosc, 2009; 69(6): 1067-1073.
- 45. Nori D, Merimsky O, Osian AD, et al. Palladium-103: a new radioactive source in the treatment of unresectable carcinoma of the pancreas: a phase Ⅰ-Ⅱ study [J]. J Surg Oncol, 1996; 61(4): 300-305.
- 46. De Oliveira R, dos Reis MP, Prado WA. The effects of early or late neurolytic sympathetic plexus block on the management of abdominal or pelvic cancer pain [J]. Pain, 2004； 110（1-2）: 400-408.
- 47. Caraceni A, Portenoy RK. Pain management in patients with pancreatic carcinoma [J]. Cancer, 1996； 78(Suppl 3): 639-653.
- 48. Wiersema MJ, Wiersema LM. Endosonography-guided celiac plexus neurolysis [J]. Gastrointest Endosc, 1996; 44(6): 656-662.
- 49. Gunaratnam NT, Sarma AV, Norton ID, et al. A prospective study of EUS-guided celiac plexus neurolysis for pancreatic cancer pain [J]. Gastrointest Endosc, 2001; 54(3): 316-324.