2017 Volume 32 Issue 1 Pages 45-49
Pancreatic juice cytology (PJC) under ERCP (ERCP/PJC) is actively performed at our institution in the assessment of intraductal papillary mucinous neoplasm (IPMN) of the pancreas because ERCP/PJC often diagnoses non-invasive pancreatic cancer concomitant with IPMN which cannot be detected by other imaging modalities. In fact, we have experienced nine non-invasive concomitant pancreatic cancers to date, and four of them were diagnosed only by ERCP/PJC. ERCP/PJC also has a role in detecting malignant IPMN in the patients with IPMN having worrisome features. If the location of non-invasive pancreatic cancer concomitant with IPMN cannot be determined, then the intraoperative irrigation cytology in the estimated remnant pancreas would be useful; however, the possibilities of the seeding of the cancer cells into the abdominal cavity during irrigation, and the false negative result of irrigation cytology remain unresolved problems. It has been recently reported that IPMNs with concomitant pancreatic cancer have such characteristics as MUC2 negative and wild type GNAS, and thus, the intensive ERCP/PJC for such high risk IPMNs might lead to the increase in the number of the patients who are diagnosed as having early stage pancreatic cancer.
