ENDOSCOPIC IMAGING AND CYTOPATHOLOGICAL/HISTOPATHOLOGICAL DIAGNOSIS IN THE DETECTION OF EARLY PANCREATIC CANCER

Abstract

Early detection of pancreatic cancer is crucial considering its extremely poor prognosis and high mortality rate. This review focuses on the application of endoscopic modalities for the diagnosis of early pancreatic cancer, specifically high-grade pancreatic intraepithelial neoplasia and invasive pancreatic cancers measuring ≤10 mm in diameter. Indirect imaging findings, such as main pancreatic duct stenosis, dilation, caliber irregularity, branch duct dilation, focal pancreatic parenchymal atrophy, and hypoechoic changes around the pancreatic duct, are valuable for identifying early pancreatic cancers in the absence of overt tumor formation. We discuss the potential for these findings to be detected using endoscopic techniques, including EUS and endoscopic retrograde pancreatography. Furthermore, we review the current role and future potential of endoscopy-based cytological and histological diagnostics for early pancreatic cancer, focusing on EUS-guided tissue acquisition and pancreatic juice cytology via nasopancreatic drainage.