Journal of medical ultrasonics (2001) · 2019
Association between hyperechogenic pancreas and pancreatic ductal adenocarcinoma concomitant with intraductal papillary mucinous neoplasms.
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Mandai Koichiro, Uno Koji, Nakase Kojiro, Kawamura Takuji, Yasuda Kenjiro
Аннотация
PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) may independently occur in the pancreas separate from an intraductal papillary mucinous neoplasm (IPMN). Therefore, identifying the characteristics of patients with IPMN who will likely develop PDAC is clinically important. Although a recent study found that fatty pancreas correlated with PDAC, no reports have examined this matter in patients with IPMN. A previous study showed that fatty pancreas increased the echogenicity; hence, this study aimed to investigate the association between hyperechogenic pancreas and PDAC in patients with IPMN.
METHODS: We retrospectively collected data of patients with IPMN who underwent endoscopic ultrasonography (EUS) between January 2012 and November 2018. A case-control analysis was performed between patients with IPMN concomitant with PDAC (cases) and those without PDAC (controls). We identified controls by matching age and sex with cases. The echogenicity of the pancreas was determined using EUS by comparing it with the left kidney or spleen. Echogenicity was determined using transabdominal ultrasonography by comparison with that of the liver when it was difficult to determine using EUS.
RESULTS: Among 400 patients with IPMN, 23 cases and 92 controls were identified. The proportion of patients with hyperechogenic pancreas was significantly greater in cases than in controls (91.3% vs. 65.2%, P = 0.02). Multivariate analysis, including family history of pancreatic cancer, multifocal cysts, and hyperechogenic pancreas, showed that hyperechogenic pancreas was correlated with PDAC concomitant with IPMN (odds ratio = 7.07; 95% confidence interval = 1.48-33.80; P = 0.01).
CONCLUSION: Our analysis demonstrated that hyperechogenic pancreas was associated with concomitant PDAC in patients with IPMN.
METHODS: We retrospectively collected data of patients with IPMN who underwent endoscopic ultrasonography (EUS) between January 2012 and November 2018. A case-control analysis was performed between patients with IPMN concomitant with PDAC (cases) and those without PDAC (controls). We identified controls by matching age and sex with cases. The echogenicity of the pancreas was determined using EUS by comparing it with the left kidney or spleen. Echogenicity was determined using transabdominal ultrasonography by comparison with that of the liver when it was difficult to determine using EUS.
RESULTS: Among 400 patients with IPMN, 23 cases and 92 controls were identified. The proportion of patients with hyperechogenic pancreas was significantly greater in cases than in controls (91.3% vs. 65.2%, P = 0.02). Multivariate analysis, including family history of pancreatic cancer, multifocal cysts, and hyperechogenic pancreas, showed that hyperechogenic pancreas was correlated with PDAC concomitant with IPMN (odds ratio = 7.07; 95% confidence interval = 1.48-33.80; P = 0.01).
CONCLUSION: Our analysis demonstrated that hyperechogenic pancreas was associated with concomitant PDAC in patients with IPMN.