臨床外科67巻11号

2012年10月発行

特集 外科医のための癌診療データ

臓器別最新データ 8．膵癌

膵癌の診断

著者： 高山敬子¹ 白鳥敬子¹

所属機関： ¹東京女子医科大学消化器内科

ページ範囲：P.222 - P.227

文献概要

覚えておきたいデータ

◆膵癌のCA19-9の感度は70～80％，Lewis血液型陰性症例では偽陰性を示す．

◆膵癌の各種画像検査での診断能は70～90％である．

◆膵癌の各種細胞診・生検の診断能は80％以上である．

参考文献

1）日本膵臓学会膵癌診療ガイドライン改訂委員会：科学的根拠に基づく膵癌診療ガイドライン．2009年度版．金原出版，2009

2）日本膵臓学会膵癌登録委員会：膵癌登録報告2007．膵臓22：e1-94，2007

3）日本超音波医学会用語・診断基準委員会：膵癌診断基準．（http://www.jsum.or.jp/committee/diagnostic/pdf/sui.pdf）

4）Freeny PC：Radiologic diagnosis and staging of pancreatic ductal adenocarcinoma. Radiol Clin North Am 27：121-128, 1989

5）Shin SS, Armao DM, Burke LM, et al：Comparison of the incidence of pancreatic abnormalities between high risk and control patients：prospective pilot study with 3 Tesla MR imaging. J Magn Reson Imaging 33：1080-1085, 2011

6）Vasen HF, Wasser M, van Mil A, et al：Magnetic resonance imaging surveillance detects early-stage pancreatic cancer in carriers of a p16-Leiden mutation. Gastroenterology 140：850-856, 2011

7）Kitano M, Kudo M, Maekawa K, et al：Dynamic imaging of pancreatic diseases by contrast enhanced coded phase inversion harmonic ultrasonography. Gut 53：854-859, 2004

8）Uchida H, Hirooka Y, Itoh A, et al：Feasibility of tissue elastography using transcutaneous ultrasonography for the diagnosis of pancreatic diseases. Pancreas 38：17-22, 2009

9）Rao SX, Zeng MS, Cheng WZ, et al：Small solid tumors（＜or＝2cm）of the pancreas：relative accuracy and differentiation of CT and MR imaging. Hepatogastroenterology 58：996-1001, 2011

10）Koelblinger C, Ba-Ssalamah A, Goetzinger P, et al：Gadobenate dimeglumine-enhanced 3.0-T MR imaging versus multiphasic 64-detector row CT：prospective evaluation in patients suspected of having pancreatic cancer. Radiology 259：757-766, 2011

11）Takakura K, Sumiyama K, Munakata K, et al：Clinical usefulness of diffusion-weighted MR imaging for detection of pancreatic cancer：comparison with enhanced multidetector-row CT. Abdom Imaging 36：457-462, 2011

12）Lopez HE, Amthauer H, Hosten N, et al：Prospective evaluation of pancreatic tumors：accuracy of MR imaging with MR cholangiopancreatography and MR angiography. Radiology 224：34-41, 2002

13）Romagnuolo J, Hoffman B, Vela S, et al：Accuracy of contrast-enhanced harmonic EUS with a second-generation perflutren lipid microsphere contrast agent. Gastrointest Endosc 73：52-63, 2011

14）Seicean A, Badea R, Stan-Iuga R, et al：Quantitative contrast-enhanced harmonic endoscopic ultrasonography for the discrimination of solid pancreatic masses. Ultraschall Med 31：571-576, 2010

15）Napoleon B, Alvarez-Sanchez MV, Gincoul R, et al：Contrast-enhanced harmonic endoscopic ultrasound in solid lesions of the pancreas：results of a pilot study. Endoscopy 42：564-570, 2010

16）Adamek HE, Albert J, Breer H, et al：Pancreatic cancer detection with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography：a prospective controlled study. Lancet 356：190-193, 2000

17）Koyama K, Okamura T, Kawabe J, et al：Diagnostic usefulness of FDG PET for pancreatic mass lesions. Ann Nucl Med 15：217-224, 2001

18）Rose DM, Delbeke D, Beauchamp RD, et al：18Fluorodeoxyglucose-positron emission tomography in the management of patients with suspected pancreatic cancer. Ann Surg 229：729-737, 1999

19）Di Stasi M, Lencioni R, Solmi L, et al：Ultrasound-guided fine needle biopsy of pancreatic masses：results of a multicenter study. Am J Gastroenterol 93：1329-1333, 1998

20）Zheng M, Liu LX, Zhu AL, et al：K- ras gene mutation in the diagnosis of ultrasound guided fine- needle biopsy of pancreatic masses. World J Gastroenterol 9：188-191, 2003

21）David O, Green L, Reddy V, et al：Pancreatic masses：a multi-institutional study of 364 fine-needle aspiration biopsies with histopathologic correlation. Diagn Cytopathol 19：423-427, 1998

22）Zech CJ, Helmberger T, Wichmann MW, et al：Large core biopsy of the pancreas under CT fluoroscopy control：results and complications. J Comput Assist Tomogr 26：743-749, 2002

23）Pellise M, Castells A, Gines A, et al：Clinical usefulness of KRAS mutational analysis in the diagnosis of pancreatic adenocarcinoma by means of endosonography-guided fine-needle aspiration biopsy. Aliment Phamacol Ther 17：1299-1307, 2003

24）Eloubeidi MA, Chen VK, Eltoum IA, et al：Endoscopic ultrasound-guided fine needle aspiration biopsy of patients with suspected pancreatic cancer：diagnostic accuracy and acute and 30-day complications. Am J Gastroenterol 98：2663-2668, 2003

25）松本学也，山雄健次，大橋計彦，他：膵疾患に対する超音波内視鏡下穿刺吸引法の有用性の検討．膵臓17：485-491，2002

26）Micames C, Jowell PS, White R, et al：Lower frequency of peritoneal carcinomatosis in patients with pancreatic cancer diagnosed by EUS-guided FNA vs. percutaneous FNA. Gastrointest Endosc 58：690-695, 2003

27）日本膵臓学会（編）：膵癌取扱い規約．第6版．金原出版，2009