Carbohydrate antigen 19-9 (CA 19-9) is a tumor marker initially identified from colorectal cancer cell lines and is currently widely used in the diagnosis and monitoring of pancreatic and biliary tract cancers. Although CA 19-9 is not routinely screened in general checkups, increasing its screening has led to the frequent detection of elevated CA 19-9 levels in asymptomatic individuals. Patients with elevated CA 19-9 levels often visit clinics for concerns about malignancy, making cancer exclusion essential to exclude cancers through detailed medical history taking, physical examination, and imaging studies. However, many cases of elevated CA 19-9 levels result from benign causes, such as pancreatobiliary diseases, hepatic diseases, pulmonary diseases, or gynecologic conditions. Thus, to avoid unnecessary tests, clinicians must understand the various causes and mechanisms of CA 19-9 elevation. Integrating the patient’s symptoms and medical and family history facilitates appropriate test selection and minimizes unnecessary procedures.

Carbohydrate antigen 19-9 (CA 19-9) is a tumor marker initially identified from colorectal cancer cell lines and is currently widely used in the diagnosis and monitoring of pancreatic and biliary tract cancers. Although CA 19-9 is not routinely screened in general checkups, increasing its screening has led to the frequent detection of elevated CA 19-9 levels in asymptomatic individuals. Patients with elevated CA 19-9 levels often visit clinics for concerns about malignancy, making cancer exclusion essential to exclude cancers through detailed medical history taking, physical examination, and imaging studies. However, many cases of elevated CA 19-9 levels result from benign causes, such as pancreatobiliary diseases, hepatic diseases, pulmonary diseases, or gynecologic conditions. Thus, to avoid unnecessary tests, clinicians must understand the various causes and mechanisms of CA 19-9 elevation. Integrating the patient’s symptoms and medical and family history facilitates appropriate test selection and minimizes unnecessary procedures.

Carbohydrate antigen 19-9 (CA 19-9) is a tumor marker initially identified from colorectal cancer cell lines and is currently widely used in the diagnosis and monitoring of pancreatic and biliary tract cancers. Although CA 19-9 is not routinely screened in general checkups, increasing its screening has led to the frequent detection of elevated CA 19-9 levels in asymptomatic individuals. Patients with elevated CA 19-9 levels often visit clinics for concerns about malignancy, making cancer exclusion essential to exclude cancers through detailed medical history taking, physical examination, and imaging studies. However, many cases of elevated CA 19-9 levels result from benign causes, such as pancreatobiliary diseases, hepatic diseases, pulmonary diseases, or gynecologic conditions. Thus, to avoid unnecessary tests, clinicians must understand the various causes and mechanisms of CA 19-9 elevation. Integrating the patient’s symptoms and medical and family history facilitates appropriate test selection and minimizes unnecessary procedures.

Background: /Aim: This study evaluated the cumulative incidence of pancreatic cancer and worrisome features (WFs) in patients with pancreatic cysts (PCs) clinically considered as branch-duct intrapapillary mucinous neoplasm (BD-IPMN). Methods: Data from 177 patients followed for BD-IPMN were retrospectively analyzed. Suspected BD-IPMN was defined as PCs with confirmed communication with the main pancreatic duct (MPD) via imaging studies, while presumed BD-IPMN referred to PCs lacking clear MPD communication. Results: Among the patients, 30.5% were categorized as suspected BD-IPMN. The median age at diagnosis was 64 years, with a median cyst size of 13 mm. At diagnosis, 19 patients (10.7%) exhibited WFs, and none of the patients had high-risk stigmata. Over a follow-up period of 70.5 months, pancreatic cancer developed in three patients, resulting in a cumulative incidence of 4.0% (95% confidence interval [CI], 0.98 to 10.76%) at 96 months. For the 158 patients without initial WFs, the cumulative incidence of WFs was 5.1% (95% CI, 2.37 to 9.28%) at 24 months and 11.2% (95% CI, 6.34 to 17.53%) at 96 months. The development of WFs was lower in the presumed BD-IPMN group (p=0.102) and among patients aged under 75 (p=0.463), though these differences were not statistically significant. Notably, the incidence of WFs plateaued after two years in the elderly cohort. Conclusions The cumulative incidence of pancreatic cancer and WFs in patients with low-risk PCs was notably low. Furthermore, discontinuing surveillance may be considered for elderly patients, especially those with no changes within the first two years of observation.

No abstract available.
Congresses as Topic ; Education, Medical ; Endoscopy ; Internet

Autoimmune pancreatitis is a rare type of chronic pancreatitis. Unlike chronic pancreatitis caused by other causes, autoimmune pancreatitis is characterized by a dramatic response to corticosteroid and immunomodulator therapy. Two most widely used drugs for treatment of autoimmune pancreatitis are corticosteroid and immunomodulators. Corticosteroid is the first line drug for autoimmune pancreatitis and used for remission induction. Remission induction rate of corticosteroid therapy is more than 90%, but relapse rate is approximately 30%. Centers in Japan and Republic of Korea prefer low-dose corticosteroid for maintenance. On the other hand, centers in North America and Europe prefer immunomodulators for maintenance. In the future, well-designed studies on methods to decrease relapse rate of autoimmune pancreatitis and effective use of immunomodulators are needed.
Adrenal Cortex Hormones ; Autoimmune Diseases ; Drug Therapy ; Europe ; Hand ; Immunologic Factors ; Japan ; North America ; Pancreatitis* ; Pancreatitis, Chronic ; Recurrence ; Remission Induction ; Republic of Korea

Development and use of linear-array echoendoscope and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) have made endoscopic ultrasound (EUS) more of an interventional procedure than a purely diagnostic procedure. This is a literature review of previously published clinical studies on EUS-guided direct intervention for solid pancreatic tumors, including EUS-guided fine needle injection (EUS-FNI) of antitumor agents, EUS-guided fiducial marker placement, EUS-guided brachytherapy and EUS-guided tumor ablation.
Antineoplastic Agents ; Brachytherapy ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Fiducial Markers ; Needles ; Pancreatic Neoplasms ; Ultrasonography

No abstract available.
Bile* ; Cholecystectomy*

No abstract available.
Diagnosis ; Pancreatic Neoplasms ; Pancreatitis