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Pancreatic Neoplasms: HELP
Articles by Àngels Ginés
Based on 13 articles published since 2008
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Between 2008 and 2019, A. Ginès wrote the following 13 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Guideline Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline - March 2017. 2017

Polkowski, Marcin / Jenssen, Christian / Kaye, Philip / Carrara, Silvia / Deprez, Pierre / Gines, Angels / Fernández-Esparrach, Gloria / Eisendrath, Pierre / Aithal, Guruprasad P / Arcidiacono, Paolo / Barthet, Marc / Bastos, Pedro / Fornelli, Adele / Napoleon, Bertrand / Iglesias-Garcia, Julio / Seicean, Andrada / Larghi, Alberto / Hassan, Cesare / van Hooft, Jeanin E / Dumonceau, Jean-Marc. ·Department of Gastroenterology, Hepatology, and Oncology, Medical Centre for Postgraduate Education, Warsaw, Poland. · Department of Gastroenterological Oncology, The M. Skłodowska-Curie Memorial Cancer Centre, Warsaw, Poland. · Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Academic Teaching Hospital of the Medical University of Brandenburg, Germany. · Nottingham Digestive Diseases Centre, NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK. · Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Italy. · Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. · Endoscopy Unit, Department of Gastroenterology, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Barcelona, Spain. · Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Université Libre de Bruxelles, Hôpital Erasme & Hôpital Saint-Pierre, Brussels, Belgium. · Pancreato-Biliary Endoscopy and Endosonography Division, San Raffaele University, Milan, Italy. · Service de Gastroentérologie, Hôpital NORD AP-HM, Aix-Marseille-Université, Marseille, France. · Gastroenterology Department Instituto Português de Oncologia do Porto, Porto, Portugal. · Anatomic Pathology Unit, AUSL of Bologna, Maggiore Hospital, Bologna, Italy. · Department of Gastroenterology, Ramsay Générale de Santé, Private Hospital Jean Mermoz, Lyon, France. · Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain. · Regional Institute of Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. · Digestive Endoscopy Unit, Catholic University, Rome, Italy. · Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands. · Gedyt Endoscopy Center, Buenos Aires, Argentina. ·Endoscopy · Pubmed #28898917.

ABSTRACT: For routine EUS-guided sampling of solid masses and lymph nodes (LNs) ESGE recommends 25G or 22G needles (high quality evidence, strong recommendation); fine needle aspiration (FNA) and fine needle biopsy (FNB) needles are equally recommended (high quality evidence, strong recommendation).When the primary aim of sampling is to obtain a core tissue specimen, ESGE suggests using 19G FNA or FNB needles or 22G FNB needles (low quality evidence, weak recommendation).ESGE recommends using 10-mL syringe suction for EUS-guided sampling of solid masses and LNs with 25G or 22G FNA needles (high quality evidence, strong recommendation) and other types of needles (low quality evidence, weak recommendation). ESGE suggests neutralizing residual negative pressure in the needle before withdrawing the needle from the target lesion (moderate quality evidence, weak recommendation).ESGE does not recommend for or against using the needle stylet for EUS-guided sampling of solid masses and LNs with FNA needles (high quality evidence, strong recommendation) and suggests using the needle stylet for EUS-guided sampling with FNB needles (low quality evidence, weak recommendation).ESGE suggests fanning the needle throughout the lesion when sampling solid masses and LNs (moderate quality evidence, weak recommendation).ESGE equally recommends EUS-guided sampling with or without on-site cytologic evaluation (moderate quality evidence, strong recommendation). When on-site cytologic evaluation is unavailable, ESGE suggests performance of three to four needle passes with an FNA needle or two to three passes with an FNB needle (low quality evidence, weak recommendation).For diagnostic sampling of pancreatic cystic lesions without a solid component, ESGE suggests emptying the cyst with a single pass of a 22G or 19G needle (low quality evidence, weak recommendation). For pancreatic cystic lesions with a solid component, ESGE suggests sampling of the solid component using the same technique as in the case of other solid lesions (low quality evidence, weak recommendation).ESGE does not recommend antibiotic prophylaxis for EUS-guided sampling of solid masses or LNs (low quality evidence, strong recommendation), and suggests antibiotic prophylaxis with fluoroquinolones or beta-lactam antibiotics for EUS-guided sampling of cystic lesions (low quality evidence, weak recommendation). ESGE suggests that evaluation of tissue obtained by EUS-guided sampling should include histologic preparations (e. g., cell blocks and/or formalin-fixed and paraffin-embedded tissue fragments) and should not be limited to smear cytology (low quality evidence, weak recommendation).

2 Guideline [Recommendations for the diagnosis, staging and treatment of pre-malignant lesions and pancreatic adenocarcinoma]. 2016

Martin-Richard, Marta / Ginès, Angels / Ayuso, Juan Ramón / Sabater, Luis / Fabregat, Joan / Mendez, Ramiro / Fernández-Esparrach, Glòria / Molero, Xavier / Vaquero, Eva C / Cuatrecasas, Miriam / Ferrández, Antonio / Maurel, Joan / Anonymous3560884. ·Servicio de Oncología Médica, Hospital Sant Pau, Barcelona, España. Electronic address: mmartinri@santpau.cat. · Servicio de Gastroenterología, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, España. · Servicio de Radiología, Hospital Clínic de Barcelona, Barcelona, España. · Servicio de Cirugía, Hospital Clínico Universitario de Valencia, Valencia, España. · Servicio de Cirugía, Hospital de Bellvitge, Barcelona, España. · Servicio de Radiología, Hospital Clínico San Carlos, Madrid, España. · Servicio de Gastroenterología, Hospital Vall d'Hebron, Barcelona, España. · Servicio de Anatomía Patológica, Hospital Clínic de Barcelona, Barcelona, España. · Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Valencia, España. · Servicio de Oncología Médica, Translational Genomics and Targeted Therapeutics in Solid Tumors Group, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, España. ·Med Clin (Barc) · Pubmed #27726847.

ABSTRACT: BACKGROUND AND OBJECTIVE: Clinical management of adenocarcinoma of the pancreas is complex, and requires a multidisciplinary approach. The same applies for the premalignant lesions that are increasingly being diagnosed. The current document is an update on the diagnosis and management of premalignant lesions and adenocarcinoma of the pancreas. PATIENTS AND METHODS: A conference to establish the basis of the literature review and manuscript redaction was organized by the Grupo Español Multidisciplinar en Cáncer Digestivo. Experts in the field from different specialties (Gastroenterology, Surgery, Radiology, Pathology, Medical Oncology and Radiation Oncology) met to prepare the present document. RESULTS: The current literature was reviewed and discussed, with subsequent deliberation on the evidence. CONCLUSIONS: Final recommendations were established in view of all the above.

3 Guideline [Recommendations for diagnosis, staging and treatment of pancreatic cancer (Part II)]. 2010

Navarro, Salvador / Vaquero, Eva / Maurel, Joan / Bombí, Josep Antoni / De Juan, Carmen / Feliu, Jaime / Fernández Cruz, Laureano / Ginés, Angels / Girela, Enrique / Rodríguez, Ricardo / Sabater, Luis / Anonymous1440657 / Anonymous1450657 / Anonymous1460657 / Anonymous1470657 / Anonymous1480657 / Anonymous1490657. ·Servicio de Gastroenterología, CIBERehd, IDIBAPS, Hospital Clínic, Universitat de Barcelona, Barcelona, España. snavarro@clinic.ub.es ·Med Clin (Barc) · Pubmed #20356609.

ABSTRACT: -- No abstract --

4 Guideline [Recommendations for diagnosis, staging and treatment of pancreatic cancer (Part I). Grupo Español de Consenso en Cáncer de Páncreas]. 2010

Navarro, Salvador / Vaquero, Eva / Maurel, Joan / Bombí, Josep Antoni / De Juan, Carmen / Feliu, Jaime / Fernández Cruz, Laureano / Ginés, Angels / Girela, Enrique / Rodríguez, Ricardo / Sabater, Luis / Anonymous44180656 / Anonymous44190656 / Anonymous44200656 / Anonymous44210656 / Anonymous44220656 / Anonymous44230656. ·Servicio de Gastroenterología, CIBERehd, IDIBAPS, Hospital Clínic, Universitat de Barcelona, Barcelona, España. snavarro@clinic.ub.es ·Med Clin (Barc) · Pubmed #20346471.

ABSTRACT: -- No abstract --

5 Review The problem of an incidental uniloculated cyst. 2014

Fernández-Esparrach, G / Ginès, A. ·Unit of Endoscopy, Department of Gastroenterology, ICMDM Hospital Clínic, IDIBAPS CIBEREHDUniversitat de Barcelona, Barcelona, Spain - mgfernan@clinic.ub.es. ·Minerva Med · Pubmed #24867189.

ABSTRACT: Incidental uniloculated cysts are diagnosed more frequently due to the increase in availability of high-quality abdominal imaging. The prevalence of incidental pancreatic cysts detected on abdominal imaging is 2.6% and is even higher in old patients. Pancreatic cysts are also found in up to 25% of autopsies, 3% of which present progression to carcinoma in situ. The most frequently incidental cysts detected are <10 mm in size and the spectrum has changed from inflammatory to mucinous lesions. Although some morphological and cytological features can help to establish the nature of these cysts, it is unclear how many of them carry a risk of malignant degeneration, how to identify those accurately, and, once recognized, how to establish which ones are likely to harbor incipient cancer and how to manage them. In the last years, some guidelines have been elaborated that summarize all the evidence published up to now and provide clinicians with useful recommendations regarding the management of pancreatic uniloculated cysts.

6 Clinical Trial Endoscopic ultrasonography-guided brushing increases cellular diagnosis of pancreatic cysts: A prospective study. 2010

Sendino, Oriol / Fernández-Esparrach, Gloria / Solé, Manel / Colomo, Lluis / Pellisé, Maria / Llach, Josep / Navarro, Salvador / Bordas, Josep M / Ginès, Angels. ·Endoscopy Unit, Department of Gastroenterology, ICMDM, IDIBAPS, CIBERehd, Hospital Clínic, Barcelona, Spain. ·Dig Liver Dis · Pubmed #20810331.

ABSTRACT: BACKGROUND: The diagnosis of pancreatic cystic lesions is still a challenge. AIM: To prospectively investigate the usefulness and safety of EUS-guided cytology brushing (EUS BR) in the cellular diagnosis of pancreatic cysts. METHODS: Cysts >15mm were sampled with a 19G needle. The fluid was aspirated and processed for cytology. The brush was introduced to scrub the cystic wall and processed as standard brushings. Antibiotic prophylaxis was administered. Complications were assessed in the first 24h and 7 days after the procedure. RESULTS: 30 patients were included. In 8 patients the technique failed for technical reasons. EUS BR provided with a cellular diagnosis in 20/22 cases (91%). The EUS BR was superior to the aspirated fluid for detecting diagnostic cells (73% vs. 36%, p=0.08) and mucinous cells (50% vs. 18%, p=0.016). In the 8 patients operated on, the specimen was consistent with EUS BR diagnosis. Three patients (10%) had complications, one of them a subacute retroperitoneal haemorrhage in a patient on anticoagulation therapy who died for complications 1 month later. CONCLUSIONS: EUS BR increases cellular diagnosis of pancreatic cystic lesions as compared with fluid analysis, mainly in mucinous lesions. Its use is not recommended in patients under anticoagulation therapy.

7 Article Endoscopic ultrasonography can avoid unnecessary laparotomies in patients with pancreatic adenocarcinoma and undetected peritoneal carcinomatosis. 2017

Alberghina, Nadia / Sánchez-Montes, Cristina / Tuñón, Carlos / Maurel, Joan / Araujo, Isis K / Ferrer, Joana / Sendino, Oriol / Córdova, Henry / Vaquero, Eva C / González-Suárez, Begoña / Martínez-Palli, Graciela / Ginès, Àngels / Fernández-Esparrach, Glòria. ·Endoscopy Unit, Gastroenterology Department, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalunya, Spain. · Oncology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalunya, Spain. · Surgical Department, ICMDiM, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalunya, Spain. · Gastroenterology Department, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalunya, Spain. · Anesthesiology Department, ICMDiM, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalunya, Spain. · Endoscopy Unit, Gastroenterology Department, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalunya, Spain. Electronic address: mgfernan@clinic.ub.es. ·Pancreatology · Pubmed #28844696.

ABSTRACT: BACKGROUND/OBJECTIVE: To assess the relationship between the presence of ascites detected by endoscopic ultrasonography (EUS) and peritoneal carcinomatosis (PC) in patients with pancreatic adenocarcinoma. METHODS: Consecutive patients who underwent a EUS for preoperative staging of a pancreatic adenocarcinoma between 1998 and 2014 were retrospectively reviewed. The diagnosis of PC was confirmed by histopathology or peritoneal fluid cytology. The main outcome of the study was the relationship of ascites at EUS and PC in patients with pancreatic cancer. Secondarily, to evaluate the relationship between this finding and survival as well as the development of PC during follow-up. RESULTS: A total of 136 patients were included: 30 patients with local unresectable tumor or metastatic disease and 106 potentially-resectable candidates based on CT staging. EUS showed ascites in 27 (20%) patients, of whom 8 (29.6%) had PC. The sensitivity, specificity, PPV, NPV and accuracy of ascites by EUS in the detection of PC in this group of patients were 67%, 85%, 30%, 96% and 83%, respectively. Ascites detected by EUS was the only independent predictive factor of PC with an OR of 11 (CI 95%: 3-40). The detection of ascites by EUS was associated with a shorter survival (median survival time 7,3 months; range 0-60 vs 14.2 months; range 0-140) (p = 0.018) and earlier development of PC during follow-up (median 3.2 months, range 1.4-18.1 vs 12.7 months, range 5.4-54.8; p = 0.003). CONCLUSION: The finding of ascites at EUS in patients with pancreatic adenocarcinoma is highly associated with PC and a poor outcome.

8 Article MicroRNAs for Detection of Pancreatic Neoplasia: Biomarker Discovery by Next-generation Sequencing and Validation in 2 Independent Cohorts. 2017

Vila-Navarro, Elena / Vila-Casadesús, Maria / Moreira, Leticia / Duran-Sanchon, Saray / Sinha, Rupal / Ginés, Àngels / Fernández-Esparrach, Glòria / Miquel, Rosa / Cuatrecasas, Miriam / Castells, Antoni / Lozano, Juan José / Gironella, Meritxell. ·*Gastrointestinal & Pancreatic Oncology Group, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)/Hospital Clínic of Barcelona/ Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Catalonia, Spain †Bioinformatics Platform, CIBEREHD/Barcelona, Catalonia, Spain ‡Pathology Department, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain. ·Ann Surg · Pubmed #27232245.

ABSTRACT: OBJECTIVE: The aim of our study was to analyze the miRNome of pancreatic ductal adenocarcinoma (PDAC) and its preneoplastic lesion intraductal papillary mucinous neoplasm (IPMN), to find new microRNA (miRNA)-based biomarkers for early detection of pancreatic neoplasia. OBJECTIVE: Effective early detection methods for PDAC are needed. miRNAs are good biomarker candidates. METHODS: Pancreatic tissues (n = 165) were obtained from patients with PDAC, IPMN, or from control individuals (C), from Hospital Clínic of Barcelona. Biomarker discovery was done using next-generation sequencing in a discovery set of 18 surgical samples (11 PDAC, 4 IPMN, 3 C). MiRNA validation was carried out by quantitative reverse transcriptase PCR in 2 different set of samples. Set 1-52 surgical samples (24 PDAC, 7 IPMN, 6 chronic pancreatitis, 15 C), and set 2-95 endoscopic ultrasound-guided fine-needle aspirations (60 PDAC, 9 IPMN, 26 C). RESULTS: In all, 607 and 396 miRNAs were significantly deregulated in PDAC and IPMN versus C. Of them, 40 miRNAs commonly overexpressed in both PDAC and IPMN were selected for further validation. Among them, significant up-regulation of 31 and 30 miRNAs was confirmed by quantitative reverse transcriptase PCR in samples from set 1 and set 2, respectively. CONCLUSIONS: miRNome analysis shows that PDAC and IPMN have differential miRNA profiles with respect to C, with a large number of deregulated miRNAs shared by both neoplastic lesions. Indeed, we have identified and validated 30 miRNAs whose expression is significantly increased in PDAC and IPMN lesions. The feasibility of detecting these miRNAs in endoscopic ultrasound-guided fine-needle aspiration samples makes them good biomarker candidates for early detection of pancreatic cancer.

9 Article Adverse events of EUS-guided FNA of pancreatic cystic and solid lesions by using the lexicon proposed in an ASGE workshop: a prospective and comparative study. 2016

Rodríguez-D'Jesús, Antonio / Fernández-Esparrach, Gloria / Marra-Lopez, Carlos / Orive-Calzada, Aitor / Sendino, Oriol / Araujo, Isis K / Rodríguez de Miguel, Cristina / Vázquez-Sequeiros, Enrique / Córdova, Henry / Sánchez-Montes, Cristina / González-Suárez, Begoña / Ginès, Angels. ·Endoscopy Unit, Gastroenterology Department, ICMDM, Hospital Clínic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain. · Hospital Universitario Araba, Vitoria-Gasteiz, Spain. · Instituto Ramón y Cajal de Investigación, Madrid, Spain. ·Gastrointest Endosc · Pubmed #26301408.

ABSTRACT: BACKGROUND AND AIMS: Pancreatic cysts and solid lesions are routinely examined by EUS-guided FNA (EUS-FNA). The aim of this study was to compare the incidence of adverse events (AEs) of this procedure by using the lexicon recommended by the American Society for Gastrointestinal Endoscopy (ASGE). METHODS: This was a prospective and comparative study of patients who underwent EUS-FNA in which a 22-gauge needle was used. In the pancreatic cystic lesions group (group I), complete fluid evacuation in a single needle pass was attempted, and ciprofloxacin was given during the procedure and for 3 days after. In the pancreatic solid lesions group (group II), the number of passes was determined by the on-site evaluation of the sample. AEs were defined and graded according to the lexicon recommended by the ASGE. Patients were followed for 48 hours, 1 week, and 1 month after the procedure. RESULTS: A total of 146 patients were included, 73 in group I and 73 in group II. Potential factors influencing the incidence of AEs (ie, access route for FNA) were similar in both groups. AEs occurred in 5 of 146 patients (3.4%; 95% confidence interval [CI], 1.3%-8%): 4 in group I (5.5%; 95% CI, 1.7%-13.7%) and 1 in group II (1.4%; 95% CI, -0.5% to 8.1%) (P = .03). Severity was mild in 1 of 5 patients (20%) and moderate in 3 of 5 patients (60%). One patient with a solid mass in the head of the pancreas had a duodenal perforation after EUS and died after surgery. All other AEs occurred in the first 48 hours and resolved with medical therapy. There were 3 incidents of transient hypoxia and self-limited abdominal pain in 1 and 2 patients, respectively. No patients were lost to follow-up. CONCLUSION: EUS-FNA of pancreatic cysts has an AEs rate similar to that of solid pancreatic masses, which is small enough to consider this procedure a safe and effective method for managing patients with both types of lesions. AEs occurred early after EUS-FNA, and patients should be closely followed during the first 2 days after the procedure.

10 Article Autoimmune pancreatitis type-1 associated with intraduct papillary mucinous neoplasm: report of two cases. 2014

Vaquero, Eva C / Salcedo, Maria T / Cuatrecasas, Míriam / De León, Hannah / Merino, Xavier / Navarro, Salvador / Ginès, Angels / Abu-Suboh, Monder / Balsells, Joaquim / Fernández-Cruz, Laureano / Molero, Xavier. ·Department of Gastroenterology, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, CIBEREHD, IDIBAPS, Barcelona, Spain. · Department of Pathology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. · Department of Pathology, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic, University of Barcelona and Banc de Tumors-Biobanc Clinic-IDIBAPS-XBTC, Barcelona, Spain. · Exocrine Pancreatic Diseases Research Group, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, CIBEREHD, Barcelona, Spain. · Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. · Department of Endoscopy, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. · Department of Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. · Department of Surgery, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, CIBEREHD, IDIBAPS, Barcelona, Spain. · Exocrine Pancreatic Diseases Research Group, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, CIBEREHD, Barcelona, Spain. Electronic address: xavier.molero@vhir.org. ·Pancreatology · Pubmed #25062884.

ABSTRACT: Chronic pancreatitis lesions usually embrace both intraduct papillary mucinous neoplasm (IPMN) and pancreatic ductal adenocarcinoma (PDAC). Patients at genetically-determined high risk of PDAC often harbor IPMN and/or chronic pancreatitis, suggesting IPMN, chronic pancreatitis and PDAC may share pathogenetic mechanisms. Chronic autoimmune pancreatitis (AIP) may also herald PDAC. Concurrent IPMN and AIP have been reported in few patients. Here we describe two patients with IPMN who developed type-1 AIP fulfilling the Honolulu and Boston diagnostic criteria. AIP diffusively affected the whole pancreas, as well as peripancreatic lymph nodes and the gallbladder. Previous pancreatic resection of focal IPMN did not show features of AIP. One of the patients carried a CFTR class-I mutation. Of notice, serum IgG4 levels gradually decreased to normal values after IPMN excision. Common risk factors to IPMN and AIP may facilitate its coincidental generation.

11 Article [Pseudopapillary solid tumor of the pancreas: report of 6 cases]. 2012

Navarro, Salvador / Ferrer, Joana / Bombí, Josep Antoni / López-Boado, Miguel Angel / Ayuso, Juan Ramón / Ginés, Angels / Fernández-Esparrach, Gloria / Vaquero, Eva / Cuatrecasas, Miriam / Fernández-Cruz, Laureano. ·Servicio de Gastroenterología, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBERehd, Barcelona, España. snavarro@clinic.ub.es ·Med Clin (Barc) · Pubmed #22036462.

ABSTRACT: BACKGROUND AND OBJECTIVES: Solid pseudopapillary neoplasms (SPNs) are rare tumours of the exocrine pancreas. Although they can develop metastasis, the prognosis is good. The aim of this study was to describe the characteristics of these tumours attended in our hospital. PATIENTS AND METHOD: All cases of SPN in the database of the Pathology Department between 1991 and 2010 were included. Age, sex, symptoms, type of surgery, pathologic and immunohistochemical characteristics, and clinical evolution were analyzed. RESULTS: Six cases were identified; all of them were women with a median age of 27.5 years. One patient presented haemoperitoneum, 2 abdominal pain and 3 were diagnosed incidentally. The most frequent localization was the pancreatic tail (n=4) and the median size was 7.7 cm. Four tumours were benign and 2 carcinomas. One of them had liver and lymph node metastases. Ki-67 proliferation index was low (1-3%). After a median follow-up of 33.5 months, all patients were alive and without evidence of relapse. CONCLUSION: SPNs occur in young women. In most cases surgical resection is curative. A low mitotic index confers a good prognosis and a long survival.

12 Article [Malignancy predictive factors in pancreatic intraductal papillary mucinous neoplasm]. 2011

Adet Caldelari, Ana Celia / Miquel, Rosa / Bombi, Josep Antoni / Ginés, Angels / Fernández-Esparrach, Gloria / Ayuso, Juan Ramón / Maurel, Joan / Feu, Faust / Castells, Antoni / Fernández-Cruz, Laureano / Navarro, Salvador. ·Servicio de Gastroenterología, Institut de Malalties Digestives i Metabòliques, IDIBAPS, CIBERehd, Barcelona, Spain. ·Med Clin (Barc) · Pubmed #21414642.

ABSTRACT: BACKGROUND AND OBJECTIVE: Intraductal papillary mucinous neoplasm (IPMN) is a premalignant lesion of the pancreas. Its natural history is not well known. We evaluated the characteristics and predictor factors of malignancy of IPMN. PATIENTS AND METHOD: A retrospective analysis was performed in 88 patients diagnosed with IPMN between January 1997 and December 2008. The diagnosis was done by abdominal computed tomography (CT), pancreatic-magnetic resonance imaging (MRI) and/or endoscopic ultrasound (EUS). Gender, age, symptoms, origin, location, CA 19.9 serum levels, size of tumours and nodules by imaging techniques, type of surgery, malignancy and survival were evaluated. Nine pre-surgical variables were selected, and univariate and multivariate analysis to identify independent prognostic factors of malignancy were performed. RESULTS: The mean age was 64 years and 53% were men. 39% of tumours were incidental. 50% had their origin on the main pancreatic duct, 37% on collateral branchs and 13% were multifocal. 68% patients were operated: 42% had malignant neoplasms (32% carcinoma in situ and 68% invasive). Twelve patients died (1 benign, 1 in situ and 10 invasive). Univariate and multivariate analysis identified the symptoms and the tumour size (≥ 22 mm [median of our serie] and ≥ 30 mm [size accepted in literature]) as independent predictor factors of malignancy. CONCLUSIONS: Many IPMN are incidental findings. The presence of symptoms and size of the tumour are independent prognostic factors of malignancy and they should be considered to decide therapeutic actions.

13 Article [Incidence and characteristics of pancreatic cystic neoplasms]. 2010

Adet, Ana / Miquel, Rosa / Bombi, Josep A / Gines, Angels / Fernández-Esparrach, Gloria / De Juan, Carmen / Ayuso, Juan R / Maurel, Joan / Castells, Antoni / Fernández-Cruz, Laureano / Navarro, Salvador. ·Servicio de Gastroenterología, IDIBAPS, CIBERehd, Institut Malalties Digestives i Metabòliques, Hospital Clinic de Barcelona, Universidad de Barcelona, Barcelona, España. ·Gastroenterol Hepatol · Pubmed #20850905.

ABSTRACT: INTRODUCTION: Cystic neoplasms (CN) of the pancreas represent 10% of cystic lesions and 1% of pancreatic tumors. Mucinous cystic neoplasm (MCN), serous cystadenoma (SC) and intraductal papillary mucinous neoplasm (IPMN) are cystic neoplasms and represent more than 90% of these types of lesion. Few series have been published on these lesions, especially in Spain. AIM: To evaluate the incidence, characteristics and survival of patients with cystic neoplasms attended in our hospital in the last 12 years. PATIENTS AND METHOD: A retrospective analysis was carried out in all patients diagnosed with CN between January 1997 and December 2008. Diagnosis was made by abdominal computed tomography, pancreatic-magnetic resonance imaging and/or endoscopic ultrasonography. Sex, age, year of diagnosis, symptoms, tumoral location and size, type of surgery, pathology, and survival were evaluated. RESULTS: A total of 117 patients were analyzed. The mean age was 63±14 years and 56% were women. Eighty-eight patients had IPMN, 21 had SC and eight had MCN. Fifty-six per cent were diagnosed in the last 4 years, 42.7% were diagnosed as an incidental finding and 19% had a history of acute pancreatitis. The most frequent location was the pancreatic head (53%). The mean imaging size was 32mm. Surgical resection was performed in 69.2% of the patients. Twenty-three percent of the tumors were malignant, 30% were carcinoma in situ and 70% were invasive. Thirteen percent of the patients died; of these 93.3% had invasive carcinoma. Five-year survival was 94.7% in SC, 76% in IPMN and 60% in MCN. CONCLUSIONS: CN were mainly identified as incidental findings, although acute pancreatitis is another possible cause. The most frequent tumor in our environment is IPMN. Surgical treatment of IPMN and MCN, at the right moment, may be useful to prevent the development of pancreatic carcinoma.