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Trial Title:
A Cohort Study on Screening and Follow-up of High-risk Population of PDAC Based on EUS
NCT ID:
NCT05621824
Condition:
Carcinoma, Pancreatic Ductal
Conditions: Official terms:
Carcinoma, Pancreatic Ductal
Conditions: Keywords:
Early Pancreatic Ductal Adenocarcinoma
Endoscopic Ultrasound
HighRisks for Pancreatic Ductal Adenocarcinoma
Study type:
Observational
Overall status:
Not yet recruiting
Study design:
Time perspective:
Prospective
Intervention:
Intervention type:
Device
Intervention name:
Endoscopic ultrasound
Description:
Use endoscopic ultrasound to examine the pancreatic lesions.
Arm group label:
Cystic lesions
Arm group label:
Solid mass
Intervention type:
Procedure
Intervention name:
EUS-Fine needle aspiration
Description:
If solid mass of pancreas was found during EUS, EUS-FNA shall be conducted for diagnosis.
Arm group label:
Cystic lesions
Arm group label:
Solid mass
Summary:
Study objective: The purpose of this study is to establish a prospective follow-up cohort
of high-risk groups of pancreatic cancer, screen early pancreatic cancer through EUS and
other means according to the existing clinical process, and evaluate each risk factors.
And to prospectively collect biological samples to find molecular markers for early
diagnosis of pancreatic cancer.
Study design: This is a real world, multicenter, prospective, observational cohort study.
Detailed description:
This study intends to conduct pancreatic MR screening for the high-risk population of
pancreatic cancer who meet the requirements and voluntarily participate in this study
(see eligibility criteria), and retain baseline information and peripheral blood, dental
plaque and stool samples.
I. For patients with solid mass of the pancreas, continue diagnosis and treatment
according to the routine clinical path.
II. For patients with MPD dilatation but no clear solid pancreatic mass, EUS examination
should be performed after excluding contraindications. During EUS, duodenal fluid samples
were collected.
III. If solid mass is found in EUS, FNA shall be performed. If the pathological
examination is positive, the patient shall be diagnosed with PDAC and treated according
to the clinical routine path of PDAC. If the pathological biopsy sample is negative,
repeat FNA after an appropriate interval (1 to 3 months later).
IV. If no solid mass is found in EUS, follow up the patient every 6-12 months for EUS
and/or MR examination.
V. For patients with cystic lesions, EUS examination is performed after contraindications
are excluded. During EUS, duodenal fluid samples were collected. If solid components such
as mural nodules or "worrisome features" are found, FNA will be performed. In order to
make a clear diagnosis of some cases, FNA+nCLE will be performed at the same time, and
cystic fluid samples will be taken to continue diagnosis and treatment according to the
clinical guidelines. If no solid lesions and "worrisome features" are found, follow up
the patient every 6-12 months and perform EUS and/or MR examinations.
VI. Follow up and perform pancreatic MR examination every 12 months for those with no
clear pancreatic lesions found on pancreatic MR.
The main outcome of this study was the discovery of pancreatic T1 PDAC (tumor diameter <
2cm), or no pancreatic disease was found during the 5-year follow-up period.
The secondary outcome of this study was the discovery of other levels of PDAC, IPMN,
chronic pancreatitis, autoimmune pancreatitis and other pancreatic diseases.
The samples involved in this study include baseline and follow-up samples (peripheral
blood, dental plaque, stool samples), EUS-FNA solid mass aspiration tissue samples or
cystic fluid samples of cystic lesions, and duodenal fluid samples collected during EUS
examination. The collected samples were analyzed by transcriptomics, proteomics and next
generation sequencing to study the clinical characteristics, molecular, flora markers and
gene sequences related to the diagnosis of early pancreatic cancer.
Criteria for eligibility:
Study pop:
Patients with high risks for pancreas cancer in Peking Union Medical College Hospital and
other related research centers in China.
Sampling method:
Non-Probability Sample
Criteria:
Inclusion Criteria:
- From the beginning of the study to the end of the study, the 18-80 year old patients
who were admitted to Peking Union Medical College Hospital and related research
centers and who met the high-risk population of pancreatic cancer understood and
were willing to participate in the study and signed the informed consent form.
- In this study, the high-risk population of pancreatic cancer is defined as patients
who meet any of the following conditions:
- A. Patients with previous history of pancreatitis (acute or chronic).
- B. Patients with pancreatic cancer related genetic background, including immediate
relatives with a family history of pancreatic cancer. Or genetic syndrome related to
pancreatic cancer. [including hereditary breast cancer ovarian cancer syndrome
(HBOCS), carney complex (CNC), familial adenomatous polyps (FAP), hereditary diffuse
gastric cancer syndrome (HDGC), juvenile polyposis (JPS), cutaneous malignant
melanoma (CMM), hereditary papillary renal cell carcinoma (HPRCC) and Lynch
syndrome]
- C. Patients with continuous or progressive increase of CA19-9 and CEA.
- D. Patients with potential malignant pancreatic tumors, including mucinous cystic
tumor (MCN) and intraductal papillary myxoma of the pancreas (IPMN).
- E. Newly diagnosed patients with diabetes (within 3 years after diagnosis of
diabetes).
- F. Other patients who are considered as having high risk factors for pancreatic
cancer.
Exclusion Criteria:
- A. Those who are not suitable for endoscopic examination, including but not limited
to: poor general condition, serious heart and lung disease, and difficult to
tolerate the examination; coagulation disorders; platelets <50 × 10^9/L;those who
are not suitable for endoscopic examination after interview by an endoscopic
physician.
- B. The patient or family member could not understand the conditions and objectives
of this study.
Gender:
All
Minimum age:
18 Years
Maximum age:
80 Years
Healthy volunteers:
No
Start date:
December 2024
Completion date:
December 2028
Lead sponsor:
Agency:
Peking Union Medical College Hospital
Agency class:
Other
Collaborator:
Agency:
Beijing Hospital
Agency class:
Other
Collaborator:
Agency:
Tongji Hospital
Agency class:
Other
Collaborator:
Agency:
The First Affiliated Hospital of Xiamen University
Agency class:
Other
Source:
Peking Union Medical College Hospital
Record processing date:
ClinicalTrials.gov processed this data on November 12, 2024
Source: ClinicalTrials.gov page:
https://clinicaltrials.gov/ct2/show/NCT05621824