A team from Chiba, Japan, determined the usefulness of peroral pancreatoscopy (POPS) and intraductal ultrasonography (IDUS) in intraductal papillary-mucinous tumor (IPMT), for the differentiation of malignant from benign disease.
They also evaluated the significance of these techniques as new preoperative examinations.
IPMT of the pancreas has attracted increasing interest because of its unique presentation. The differential diagnosis between malignant and benign tumors is extremely important in the determination of the therapy for IPMT.
A total of 60 histopathologically confirmed patients with IPMT underwent POPS and/or IDUS preoperatively. POPS was performed in all patients, and IDUS in 40.
|POPS and IDUC:|
- Improve IPMT differential diagnosis
- Help determine effective therapy
| Gastroenterology |
Findings of POPS and IDUS were compared with histopathology of resected specimens, and the postoperative follow-up data were analyzed.
Using POPS, the researchers detected protruding lesions in 40 patients. These were classified into 5 groups. Fish-egg-like type with vascular images, villous type, and vegetative type were considered to be malignant.
By IDUS, lesions protruding 1 mm or more were observed in 36 patients.
Of the lesions protruding 4 mm or more, 88% were found to be malignant.
Combination of POPS and IDUS improved the differential diagnosis between benign and malignant IPMT.
The investigators found that the 3-year cumulative survival rate and disease-free survival rate were extremely high at 95% and 93%, respectively.
Author Taro Hara, of the Chiba University School of Medicine, concluded on behalf of the group, "The combination of POPS and IDUS results in a considerably improved differential diagnosis between malignant and benign IPMT, and is useful for determining an effective therapeutic approach.
"These new techniques can contribute to improvements in postoperative results."