Esophagogastroduodenal Findings in Patients with Intraductal Papillary Mucinous Neoplasms

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2023 Jun 28

PMID 37371022

Authors

Dana Zelnik Yovel

Erwin Santo

Majd Khader

Roie Tzadok

Nir Bar

Asaf Aizic

Oren Shibolet

Dana Ben-Ami Shor

Affiliations

Soon will be listed here.

Abstract

The association between intraductal papillary mucinous neoplasms (IPMNs) and extra-pancreatic malignancies is controversial. This cross-sectional study compared esophagogastroduodenal findings in 340 IPMN patients to those of age- and gender-matched controls without known IPMNs who underwent esophagogastroduodenoscopies (EGDs) for similar clinical reasons. The presence of gastric and esophageal cancer, Barrett's esophagus, neuroendocrine tumors (NETs), gastrointestinal stromal tumors (GISTs), gastric adenomas, and ampullary tumors was assessed. The results showed that 4/340 (1.2%) of the IPMN patients had gastric cancer and 1/340 (0.3%) had esophageal cancer. The matched control group had a similar incidence of gastric cancer (5/340) (1.5%), with no esophageal cancer cases ( > 0.999). The overall incidence of other esophagogastroduodenal conditions did not significantly differ between the IPMN patients and the controls. However, the incidence of gastric cancer in the IPMN patients was higher than expected based on national cancer registry data (standardized incidence ratio of 31.39; < 0.001; CI 8.38-78.76). In conclusion, IPMN patients have a significantly higher incidence of gastric cancer compared to the general population. However, the incidence of esophagogastroduodenal findings, including gastric and esophageal cancer, is similar between IPMN patients and those who undergo an EGD for similar clinical indications. Further research is needed to determine optimal surveillance strategies for IPMN patients regarding their risk of developing gastric cancer.

References

Roch A, Rosati C, Cioffi J, Ceppa E, DeWitt J, Al-Haddad M . Intraductal papillary mucinous neoplasm of the pancreas, one manifestation of a more systemic disease?. Am J Surg. 2016; 211(3):512-8. DOI: 10.1016/j.amjsurg.2015.12.009. View

Jin Oh S, Lee S, Lee H, Paik Y, Lee D, Lee K . [Extrapancreatic tumors in intraductal papillary mucinous neoplasm of the pancreas]. Korean J Gastroenterol. 2009; 54(3):162-6. DOI: 10.4166/kjg.2009.54.3.162. View

Zelnik Yovel D, Bear L, Scapa E, Shnell M, Bar Yishay I, Bar N . Increased prevalence of colorectal neoplasia in patients with intraductal papillary mucinous neoplasms. Therap Adv Gastroenterol. 2022; 15:17562848221104306. PMC: 9210092. DOI: 10.1177/17562848221104306. View

Riall T, Stager V, Nealon W, Townsend Jr C, Kuo Y, Goodwin J . Incidence of additional primary cancers in patients with invasive intraductal papillary mucinous neoplasms and sporadic pancreatic adenocarcinomas. J Am Coll Surg. 2007; 204(5):803-13. DOI: 10.1016/j.jamcollsurg.2007.01.015. View

Oyama H, Tada M, Takagi K, Tateishi K, Hamada T, Nakai Y . Long-term Risk of Malignancy in Branch-Duct Intraductal Papillary Mucinous Neoplasms. Gastroenterology. 2019; 158(1):226-237.e5. DOI: 10.1053/j.gastro.2019.08.032. View

Tada M, Kawabe T, Arizumi M, Togawa O, Matsubara S, Yamamoto N . Pancreatic cancer in patients with pancreatic cystic lesions: a prospective study in 197 patients. Clin Gastroenterol Hepatol. 2006; 4(10):1265-70. DOI: 10.1016/j.cgh.2006.07.013. View

Elta G, Enestvedt B, Sauer B, Lennon A . ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts. Am J Gastroenterol. 2018; 113(4):464-479. DOI: 10.1038/ajg.2018.14. View

Yoon W, Ryu J, Kyu Lee J, Woo S, Lee S, Park J . Extrapancreatic malignancies in patients with intraductal papillary mucinous neoplasm of the pancreas: prevalence, associated factors, and comparison with patients with other pancreatic cystic neoplasms. Ann Surg Oncol. 2008; 15(11):3193-8. DOI: 10.1245/s10434-008-0143-4. View

Ishida M, Egawa S, Kawaguchi K, Aoki T, Sakata N, Mikami Y . Synchronous and metachronous extrapancreatic malignant neoplasms in patients with intraductal papillary-mucinous neoplasm of the pancreas. Pancreatology. 2008; 8(6):577-82. DOI: 10.1159/000159844. View

10.

Kawakubo K, Tada M, Isayama H, Sasahira N, Nakai Y, Yamamoto K . Incidence of extrapancreatic malignancies in patients with intraductal papillary mucinous neoplasms of the pancreas. Gut. 2011; 60(9):1249-53. DOI: 10.1136/gut.2010.227306. View

11.

Matsubara A, Sekine S, Kushima R, Ogawa R, Taniguchi H, Tsuda H . Frequent GNAS and KRAS mutations in pyloric gland adenoma of the stomach and duodenum. J Pathol. 2012; 229(4):579-87. DOI: 10.1002/path.4153. View

12.

Kamisawa T, Tu Y, Egawa N, Nakajima H, Tsuruta K, Okamoto A . Malignancies associated with intraductal papillary mucinous neoplasm of the pancreas. World J Gastroenterol. 2005; 11(36):5688-90. PMC: 4481489. DOI: 10.3748/wjg.v11.i36.5688. View

13.

Pugliese L, Keskin M, Maisonneuve P, DHaese J, Marchegiani G, Wenzel P . Increased incidence of extrapancreatic neoplasms in patients with IPMN: Fact or fiction? A critical systematic review. Pancreatology. 2015; 15(3):209-16. DOI: 10.1016/j.pan.2015.03.007. View

14.

Tanaka M, Fernandez-Del Castillo C, Kamisawa T, Jang J, Levy P, Ohtsuka T . Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 2017; 17(5):738-753. DOI: 10.1016/j.pan.2017.07.007. View

15.

Matthaei H, Wu J, Dal Molin M, Shi C, Perner S, Kristiansen G . GNAS sequencing identifies IPMN-specific mutations in a subgroup of diminutive pancreatic cysts referred to as "incipient IPMNs". Am J Surg Pathol. 2014; 38(3):360-3. PMC: 3927228. DOI: 10.1097/PAS.0000000000000117. View

16.

Larghi A, Panic N, Capurso G, Leoncini E, Arzani D, Salvia R . Prevalence and risk factors of extrapancreatic malignancies in a large cohort of patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas. Ann Oncol. 2013; 24(7):1907-1911. DOI: 10.1093/annonc/mdt184. View

17.

Furukawa T, Kuboki Y, Tanji E, Yoshida S, Hatori T, Yamamoto M . Whole-exome sequencing uncovers frequent GNAS mutations in intraductal papillary mucinous neoplasms of the pancreas. Sci Rep. 2012; 1:161. PMC: 3240977. DOI: 10.1038/srep00161. View

18.

Eguchi H, Ishikawa O, Ohigashi H, Tomimaru Y, Sasaki Y, Yamada T . Patients with pancreatic intraductal papillary mucinous neoplasms are at high risk of colorectal cancer development. Surgery. 2006; 139(6):749-54. DOI: 10.1016/j.surg.2005.11.008. View

19.

Khan S, Sclabas G, Reid-Lombardo K . Population-based epidemiology, risk factors and screening of intraductal papillary mucinous neoplasm patients. World J Gastrointest Surg. 2010; 2(10):314-8. PMC: 2999209. DOI: 10.4240/wjgs.v2.i10.314. View

20.

Yamanoi K, Nakayama J . Reduced αGlcNAc glycosylation on gastric gland mucin is a biomarker of malignant potential for gastric cancer, Barrett's adenocarcinoma, and pancreatic cancer. Histochem Cell Biol. 2018; 149(6):569-575. DOI: 10.1007/s00418-018-1667-8. View