超声内镜引导细针穿刺活检对胰腺占位性病变的诊断价值

目的探讨超声内镜引导下细针穿刺活检(EUS-FNA)对胰腺占位性病变的诊断价值。方法回顾分析2009年1月至2010年1月间行EUS-FNA的35例胰腺占位病例,与CT、B超、临床表现等进行对比分析,依病理学和细胞学检查或随访结果确诊。结果在所有35例患者中,最后确诊胰腺癌23例、慢性胰腺炎9例、导管内黏液性乳头状瘤1例、胰腺假性囊肿1例、浆液性囊腺瘤1例。B超共检出胰腺病变22例,CT29例,EUS发现35例可疑胰腺病变。对所有患者均行EUS-FNA检查,获得满意标本34例,取材满意率97.14%。EUS-FNA诊断胰腺癌17例,敏感性为73.91%,EUS-FNA总准确率为82.86%。5例患者EUS-FNA后出现淀粉酶及脂肪酶轻度升高,治疗后很快恢复正常。结论 EUS-FNA是病理学诊断胰腺占位性病变安全而有效的方法,应作为首选。     

胰腺细针穿刺标本中粘蛋白MUC1、MUC5AC的临床意义

目的 检测胰腺细针穿刺标本中粘蛋白MUC1、MUC5AC的临床意义.方法 对54例胰腺占位病变的EUS-FNA活检标本采用SP免疫组化法检测粘蛋白MUC1、MUC5AC表达,根据临床综合判断的诊断,与细胞学和组织学检查结果比较,评价其诊断价值.结果 54例患者最后确诊为胰腺癌38例,胰腺良性肿瘤6例,慢性胰腺炎10例.细胞学和组织学的诊断敏感性分别为31.6%和47.4%.MUC1、MUC5AC、MUC1 + MUC5AC在胰腺癌EUS-FNA标本组织中的阳性表达率为81.6%、84.2%和76.3%,显著高于胰腺良性疾病的25%、43.8%和6.3%的表达(P ＜ 0.01).细胞学和组织学检查结合MUC1和MUC5AC的检测诊断胰腺癌的敏感性可提高到84.2%,特异性达100%.结论 检测胰腺FNA标本中粘蛋白MUC1、MUC5AC的表达有助于提高对胰腺癌的诊断.     

胰腺细针穿刺标本中粘蛋白MUC1、MUC5AC的临床意义

目的检测胰腺细针穿刺标本中粘蛋白MUC1、MUC5AC的临床意义。方法对54例胰腺占位病变的EUS-FNA活检标本采用SP免疫组化法检测粘蛋白MUC1、MUC5AC表达,根据临床综合判断的诊断,与细胞学和组织学检查结果比较,评价其诊断价值。结果54例患者最后确诊为胰腺癌38例,胰腺良性肿瘤6例,慢性胰腺炎10例。细胞学和组织学的诊断敏感性分别为31.6%和47.4%。MUC1、MUC5AC、MUC1 MUC5AC在胰腺癌EUS-FNA标本组织中的阳性表达率为81.6%、84.2%和76.3%,显著高于胰腺良性疾病的25%、43.8%和6.3%的表达(P<0.01)。细胞学和组织学检查结合MUC1和MUC5AC的检测诊断胰腺癌的敏感性可提高到84.2%,特异性达100%。结论检测胰腺FNA标本中粘蛋白MUC1、MUC5AC的表达有助于提高对胰腺癌的诊断。     

胰腺超声内镜细针穿刺活检组织中粘蛋白表达检测辅助诊断胰腺癌的价值评价

目的 检测粘蛋白（MUCl、MUC2、MUC5AC）在胰腺超声内镜细针穿刺（EUS-FNA）组织标本中的表达，评价其对胰腺癌辅助诊断的价值。方法 收集54例胰腺占位病变的EUS-FNA组织标本，采用S-P免疫组化法检测粘蛋白（MUCl、MUC2、MUC5AC）的表达，根据临床综合判断的诊断，与细胞学检查结果比较，评价其诊断价值。结果 54例患者最后确诊为胰腺癌38例，胰腺良性肿瘤6例，慢性胰腺炎10例。细胞学和组织学的诊断敏感性分别为31．6％和47．4％。MUC1、MUC2、MUC5AC在胰腺癌EUS-FNA标本组织中的阳性表达率为81．6％（31／38）、10．5％（4／38）、84．2％（32／38），在胰腺良性疾病组织标本中分别25％（4／16）、31．3％（5／16）、43．8％（7／16），其中MUCl和MUC5AC两组间差异有统计学意义（P〈0．01）。MUCl的表达与胰腺癌的临床分期、淋巴结转移呈正相关。将细胞组织学检查结合MUCl和MUC5AC表达检测诊断胰腺癌的敏感性可提高至89．5％。结论胰腺EU$-FNA组织标本中MUCl、MUC5AC的检测对胰腺癌有临床辅助诊断价值，且MUCl还能预测胰腺癌的临床分期及淋巴结转移。     

超声内镜引导下细针穿刺活检组织中S100A6mRNA水平对胰腺癌的诊断价值

目的 研究对超声内镜引导下细针穿刺活检(EUS-FNA)胰腺癌(PDA)组织进行S100A6基因mRNA表达水平检测的可行性和其对PDA的诊断价值.方法 收集18份PDA患者手术切除胰腺标本及22份相对正常胰腺标本,抽提标本RNA进行逆转录,行荧光定量PCR测定S100A6基因表达水平,通过受试者工作特征曲线(ROC)分析确立S100A6 mRNA表达水平用于检测PDA的诊断界值.选取28例因胰头占位行EUS-FNA的患者,前瞻性评价EUS-FNA标本中S100A6 mRNA表达水平对PDA的术前诊断价值.通过免疫组织化学染色观察S100A6蛋白在PDA中的表达情况.结果 PDA患者EUS-FNA标本和手术标本中S100A6 mRNA表达水平(0.05023±0.10120,0.02083±0.02848)显著高于相对正常胰腺组织(0.00164±0.00202),差异有统计学意义(均P＜0.01).22例PDA患者EUS-FNA标本的S100A6表达水平显著高于6例胰腺良性疾病穿刺标本(0.00193±0.00278,P=0.0009),6例胰腺良性疾病穿刺标本与相对正常胰腺手术标本中S100A6表达水平无差异(P=0.6143).以EUS-FNA标本中S100A6 mRNA表达水平＞0.00525为阳性诊断标准,前瞻性检测PDA的敏感度、特异度、准确度分别为90.01％、100％和92.85％.结论 EUS-FNA标本中S100A6基因mRNA在PDA中高水平表达,具有良好的术前诊断价值.     

内镜超声引导下细针穿刺活检术对腹腔占位病灶的诊断价值

目的探讨内镜超声引导下细针穿刺活检术(EUS-FNA)对腹腔占位病灶的诊断价值和安全性。方法收集2009-05～2011-06因腹腔占位行EUS-FNA的患者19例,回顾性分析EUS-FNS病理的阳性率及EUS-FNA与手术后病理的符合率。结果 19例患者穿刺病理结果,腺癌11例,假性乳头状瘤1例,胰腺导管内乳头状黏液瘤(IPMT)1例,炎性改变6例,穿刺检查阳性率为68.4%。其中7例行手术治疗,术后病理与穿刺标本病理或细胞学结果符合6例,符合率为86.0%。本组19例患者EUS-FNA术后无出血、穿孔、感染及急性胰腺炎等并发症。结论 EUS-FNA是一项准确而安全有效的技术,对腹腔占位病灶尤其是胰腺肿瘤的定性诊断及进一步治疗方案的确定具有重要的临床价值。     

超声内镜引导下细针穿刺对胰腺肿瘤的诊断价值

目的探讨超声内镜引导下细针穿刺活检(EUSFNA)对胰腺肿瘤的诊断价值。方法分析2012年8月至2014年7月间中山市人民医院门诊及住院患者,行CT检查提示胰腺癌,行EUS-FNA的患者,根据穿刺病理学和细胞学检查结果确诊。结果 26例患者中,超声内镜检查26例均表现为低回声边界不规则病灶,其中24例经病理和细胞学诊断为胰腺癌后经手术证实诊断,1例病理检查和细胞学诊断提示炎性上皮细胞,术后病理证实为慢性胰腺炎并囊腺瘤。1例病理检查和细胞学诊断提示炎性上皮细胞,术后病理证实为慢性胰腺炎。结论 EUS-FNA是病理学诊断胰腺肿瘤安全而有效的方法 ,应作为首选。     

内镜超声引导下细针穿刺抽吸术对胰腺癌的诊断价值

目的探讨内镜超声引导下细针穿刺抽吸术（EUS-FNA）对胰腺占位性病变特别是胰腺癌的诊断价值。方法对2005年后经B超、CT、MRI等影像学诊断和（或）临床疑诊胰腺癌的37例患者,在EUS引导下对病变作细针穿刺抽吸活检（FNA）,对于囊实性病变同时抽取囊液化验淀粉酶及肿瘤标志物等指标。结果EUS-FNA检出胰腺导管细胞癌16例,转移性肾细胞癌1例,可疑癌5例,异型细胞6例,正常胰腺组织6例,非胰腺成分3例。随访至2008年7月时,已证实胰腺癌25例,良性10例（慢性胰腺炎4例,囊腺瘤4例,假性囊肿2例）,尚有2例无法确诊。EUS-FNA诊断胰腺癌的敏感性为80．0％（95％CI：59．0-93．0）,特异性为100．0％（95％CI：60．0—100．0）,阳性预测值为100．0％（95％CI：80．0-100．0）,阴性预测值为55．6％（95％CI：27．0-79．0）。6例病变获取囊液进行淀粉酶、肿瘤标志物分析。本组EUS-FNA术后无严重并发症发生。结论EUS-FNA是一项安全有效的操作,对于胰腺占位性病变尤其是胰腺癌的诊断具有重要的意义。     

胰腺癌内镜超声引导下细针穿刺活检物中肿瘤标志物检测价值研究

目的 探讨检测内镜超声引导下细针穿刺(EUS-FNA)活检物中CEA、CA19-9常用肿瘤标志物对胰腺癌诊断的价值.方法 2004年6月至2006年1月间的65例胰腺癌患者和25例慢性胰腺炎患者行EUS-FNA,采用电化学发光法对EUS-FNA活检物的离心上清进行CEA、CA19-9检测,并与该患者外周静脉血清中的CEA、CA19-9进行对比和分析.随后对临床可疑胰腺癌而EUS-FNA病理学检测阴性的12例的病例进行随访,观察该方法诊断胰腺癌的敏感性.结果 (1)胰腺癌患者中EUS-FNA标本中CEA和CA19-9均高于血清(P＜0.01).慢性胰腺炎患者EUS-FNA标本与血清中的CEA(P=0.122)和CA19-9(P=0.035)都没有明显差别.(2)对于EUS-FNA标本,胰腺癌中的CEA、CA19-9高于慢性胰腺炎(P＜0.01).对于血清标本,慢性胰腺炎与胰腺癌中的CEA没有明显差别(P=0.079),胰腺癌中的CA19-9高于慢性胰腺炎患者(P＜0.01).(3)12例可疑胰腺癌随访后确诊10例为胰腺癌,2例为慢性胰腺炎.对于胰腺癌的诊断,血清CEA的敏感性为30%,血清CA19-9为70%;EUS-FNA活检物中CEA和CA19-9的预测敏感性均为90%.结论 胰腺癌EUS-FNA活检物中的CEA、CA19-9对提高胰腺癌诊断的敏感性具有较高的临床实用价值,为提高胰腺癌的诊断率提供了一种新的方法.     

内镜超声引导下细针穿刺抽吸术对纵隔占位病变的诊断价值及安全性

内镜超声引导下细针穿刺抽吸术(EUS-FNA)是指在内镜超声实时引导下对病变部位进行细针穿刺获取细胞、组织或体液标本,从而获得细胞学和(或)病理学等诊断的检查方法.近年来,EUS-FNA已广泛应用于胰腺疾病的诊断,随着内镜技术的发展,其在消化道管壁临近组织占位的诊断中也得到越来越多地应用[1 ].本研究通过对84例经E...     

Establishment of Patient-Derived Pancreatic Cancer Organoids from Endoscopic Ultrasound-Guided Fine-Needle Aspiration Biopsies

Background/AimsThree-dimensional cultures of human pancreatic cancer tissue also known as “organoids” have largely been developed from surgical specimens. Given that most patients present with locally advanced and/or metastatic disease, such organoids are not representative of the majority of patients. Therefore, we used endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) to collect pancreatic cancer tissues from patients with advanced pancreatic cancer to create organoids, and evaluated their utility in pancreatic cancer research.MethodsSingle-pass EUS-FNA samplings were employed to obtain the tissue for organoid generation. After establishment of the organoid, we compared the core biopsy tissues with organoids using hematoxylin and eosin staining, and performed whole exome sequencing (WES) to detect mutational variants. Furthermore, we compared patient outcome with the organoid drug response to determine the potential utility of the clinical application of such organoid-based assays.ResultsOrganoids were successfully generated in 14 of 20 tumors (70%) and were able to be passaged greater than 5 times in 12 of 20 tumors (60%). Among them, we selected eight pairs of organoid and core biopsy tissues for detailed analyses. They showed similar patterns in hematoxylin and eosin staining. WES revealed mutations in KRAS, TP53, CDKN2A, SMAD4, BRCA1, and BRCA2 which were 93% homologous, and the mean nonreference discordance rate was 5.47%. We observed moderate drug response correlations between the organoids and clinical outcomes in patients who underwent FOLFIRINOX chemotherapy.ConclusionsThe established organoids from EUS-FNA core biopsies can be used for a suitable model system for pancreatic cancer research.     

不同细胞病理学分级标准对超声内镜引导下细针穿刺诊断胰腺癌的影响

目的探讨不同细胞病理学分级标准对超声内镜引导下细针穿刺(EUS-FNA)诊断胰腺癌效能的影响。方法收集2011年5月—2019年3月于安徽医科大学第一附属医院行EUS-FNA检查的256例胰腺占位患者的临床资料和胰腺细胞病理学诊断结果,以手术病理结果和随访情况作为最终诊断,评估影响EUS-FNA诊断效能的相关因素。计量资料两组间比较采用独立样本t检验或Mann-Whitney U检验;计数资料两组间比较采用χ^2检验。应用受试者工作特征曲线(ROC曲线)评价不同细胞病理学分级标准对胰腺癌的诊断价值。结果剔除失访患者67例,共189例患者纳入研究,按巴氏细胞病理学标准,EUS-FNA诊断细胞病理学结果为异型细胞47例,疑癌细胞25例,癌细胞20例,未见肿瘤细胞97例。133例经术后病理和随访结果证实为胰腺癌,其中细胞病理学检查结果分别为:未见肿瘤细胞52例,异型细胞36例,疑癌细胞25例,癌细胞20例。EUS-FNA诊断胰腺癌的真阳性率为60.90%(81例),假阴性率为39.10%(52例);非胰腺癌56例,假阳性率为19.64%(11例),真阴性率为80.36%(45例)。EUS-FNA诊断胰腺癌的ROC曲线下面积为0.643(95%CI:0.561~0.724)。联合不同细胞病理学分级标准,分别以“发现异型细胞或可疑癌细胞或癌细胞均为阳性”“发现可疑癌细胞或癌细胞均为阳性”和“发现癌细胞为阳性”为诊断标准进行分析,结果显示,以“发现异型细胞或可疑癌细胞或癌细胞均为阳性”为诊断标准,EUS-FNA诊断胰腺癌的效能提高,敏感度为50.38%,特异度为75.00%。189例患者EUS-FNA术后并发症发生率为6.88%(13例),主要为高淀粉酶血症和腹痛。结论联合不同细胞病理学分级标准有助于提高EUS-FNA对胰腺癌的诊断效能。     

Comparison of cytological and histological preparations in the diagnosis of pancreatic malignancies using endoscopic ultrasound-guided fine needle aspiration

BACKGROUND:Endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) has become a crucial diagnostic technique for pancreatic malignancies.The specimen obtained by EUS-FNA can be prepared for either cytological or histological examinations.This study was to compare diagnostic performance of cytological and histological preparations using EUSFNA in the same lesions when pancreatic malignancies were suspected.METHODS:One hundred and eighteen patients who underwent EUS-FNA for suspected pancreatic malignancies were consecutively enrolled.All procedures were conducted by a single echoendoscopist under the same conditions.Four adequate preparations were obtained by 22-gauge needles with 20 to-and-fro movements for each pass.The 4 preparations included 2 cytological and 2 histological specimens.The pathologic reviews of all specimens were conducted independently by a single experienced cytopathologist.Sensitivity,specificity,and accuracy of the 2 preparations were compared.RESULTS:The enrolled patients consisted of 62 males(52.5%),with the mean age of 64.6±10.5 years.Surgery was performed in 23(19.5%) patients.One hundred and sixteen(98.3%) lesions were classified as malignant,while 2(1.7%) were benign.Sensitivity of cytology and histology were 87.9% and 81.9%,respectively,with no significant difference(P=0.190).Accuracy was also not significantly different.Cytological preparation was more sensitive when the size of lesion was 3 cm(86.7% vs 68.9%,P=0.033).CONCLUSIONS:Our results suggested that the diagnostic performances of cytological and histological preparations are not significantly different for the diagnosis of pancreatic malignancies.However,cytological preparation might be more sensitive for pancreatic lesions 3 cm.     

Endoscopic ultrasound-guided fine needle aspiration and multidetector spiral CT in the diagnosis of pancreatic cancer

INTRODUCTION: Endoscopic ultrasound (EUS) is now established as a valuable imaging test for diagnosing and staging pancreatic cancer. But, with significant recent improvements in spiral CT scanners, particularly higher resolution and ability to reconstruct 3D images, spiral CT is now increasingly accepted as being better for pancreatic cancer staging. The debate continues, however, about the best diagnostic test or combination of tests in patients with suspected pancreatic cancer. Spiral CT is more readily available than EUS-FNA and, therefore, more frequently used. In this study, we evaluated the use of EUS-FNA in conjunction with spiral CT for suspected pancreatic cancer. METHODS: We retrospectively evaluated 81 consecutive patients who underwent EUS and EUS-FNA for clinical suspicion of a pancreatic cancer from November 2000 to November 2001. All patients had spiral CT with a multiphasic pancreatic protocol using multidetector spiral CT scanners. In all patients, EUS-FNA and spiral CT examinations were performed less than 3 wk apart. RESULTS: Overall, the accuracy of spiral CT, EUS, and EUS-FNA was 74% (n = 60/81, CI 63-83%), 94% (n = 76/81, CI 87-98%), and 88% (n = 73/81, CI 81-96%), respectively, for diagnosing pancreatic cancer. In patients without an identifiable mass on spiral CT, the diagnostic accuracy of EUS and EUS-FNA for pancreatic tumors was 92% (n = 23/25, CI 74-99%). Absence of a focal "mass" lesion on EUS reliably excluded pancreatic cancer irrespective of clinical presentation (NPV 100% n = 5/5, CI 48-100%). The negative predictive value of EUS-FNA was only 22% (n = 2/9, CI 3-60%) in patients with obstructive jaundice and biliary stricture. However, in patients without obstructive jaundice at initial presentation, EUS-FNA was highly accurate (accuracy 97%, n = 33/34, CI 85-100%) and was reliable for ruling out malignancy (NPV 89%, n = 8/9, CI 52-100%). Cytologic assessment of EUS-FNA specimens was 89% accurate for identifying malignancy in suspicious lesions visualized on EUS. CONCLUSIONS: The EUS with FNA can be a valuable adjunct to newer high-resolution multidetector spiral CT for diagnostic evaluation of patients with suspected pancreatic cancer.     

Comparative study of diagnostic value of cytologic sampling by endoscopic ultrasonography-guided fine-needle aspiration and that by endoscopic retrograde pancreatography for the management of pancreatic mass without biliary stricture

BACKGROUND: Endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) can now provide a cytopathological diagnosis of underlying pancreatic malignancy with higher success rates than endoscopic retrograde pancreatography (ERP). To determine the significance of EUS-FNA for the diagnosis of pancreatic mass without biliary stricture, the value of cytopathological diagnosis obtained by EUS-FNA was retrospectively compared with that by ERP, and the complications associated with these procedures evaluated. METHODS: Eighty-three patients who were suspected to have a pancreatic mass (excluding a cystic mass), without biliary stricture on conventional ultrasound and/or computed tomography were enrolled. The EUS-FNA biopsy was performed in 53 patients and cytology utilizing ERP was performed in 30 patients. RESULTS: The sampling rate of adequate specimen was 100% in both groups. In the EUS-FNA group, the overall results for the available samples were sensitivity 92.9% and accuracy 94.3%. In contrast, in the ERCP group, the overall results were sensitivity 33.3% and accuracy 46.7%. There was a significant difference between the two groups (P < 0.01). With regard to complications, there was a significant difference (P < 0.01) in the frequency of post-procedure pancreatitis between the EUS-FNA group and ERP group (0%, 0/53 vs 33.3%, 10/30, respectively). CONCLUSION: Endoscopic ultrasonography-guided fine-needle aspiration is safer and more accurate for the cytopathological diagnosis of suspected pancreatic masses without a biliary stricture as compared with cytology during ERP. Endoscopic ultrasonography with FNA should be considered a preferred test (prior to attempting endoscopic retrograde cholangiopancreatography) when a cytological diagnosis of a pancreatic mass is required, especially when there is no biliary obstruction, or when emergent decompression of an obstructed biliary tree is not considered clinically necessary due to lack of signs and symptoms of cholangitis.     

内镜超声引导下细针穿刺胰腺癌门静脉血测定循环肿瘤细胞的临床研究

目的评估用内镜超声引导下细针抽吸术(EUS-FNA)于胰腺癌门静脉采血检测循环肿瘤细胞(CTCs)的安全性及有效性。方法该研究为一项前瞻性单中心临床研究,纳入5例胰腺癌患者,行EUS-FNA门静脉采血。以外周血CTCs为对照,采用阴性免疫磁珠联合FISH法和叶酸受体阳性CTCs检测试剂盒检测门静脉血和外周血CTCs的细胞含量。结果5例患者EUS-FNA下门静脉采血均成功。1例出现血液凝集,未能进行CTCs检测。4例患者进行检测,3例门静脉血和外周血检测到CTCs。其中门静脉血CTCs细胞含量为(10.5±4.0)FU/3.7 mL,外周血CTCs含量为(11.4±4.2)FU/3.7 mL,两组比较差异无统计学意义(P>0.05)。术中术后无感染、腹腔出血和休克等并发症。结论内镜超声引导下胰腺癌门静脉血CTCs测定是一项安全可行的方法,可有助于胰腺癌早期转移的预估和治疗方案的选择。     

Lower frequency of peritoneal carcinomatosis in patients with pancreatic cancer diagnosed by EUS-guided FNA vs. percutaneous FNA

BACKGROUND: Studies have suggested an increased risk of peritoneal seeding in patients with pancreatic cancer diagnosed by percutaneous FNA. EUS-FNA is an alternate method of diagnosis. The aim of this study was to compare the frequency of peritoneal carcinomatosis as a treatment failure pattern in patients with pancreatic cancer diagnosed by EUS-FNA vs. percutaneous FNA. METHODS: Retrospective review of patients with non-metastatic pancreatic cancer identified 46 patients in whom the diagnosis was made by EUS-FNA and 43 with the diagnosis established by percutaneous FNA. All had neoadjuvant chemoradiation. Patients underwent restaging CT after completion of therapy, followed by attempted surgical resection if there was no evidence of disease progression. RESULTS: There were no significant differences in tumor characteristics between the two study groups. In the EUS-FNA group, one patient had developed peritoneal carcinomatosis compared with 7 in the percutaneous FNA group (2.2% vs. 16.3%; p<0.025). No patient with a potentially resectable tumor in the EUS-FNA group had developed peritoneal carcinomatosis. CONCLUSIONS: Peritoneal carcinomatosis may occur more frequently in patients who undergo percutaneous FNA compared with those who have EUS-FNA for the diagnosis of pancreatic cancer. A concern for peritoneal seeding of pancreatic cancer via percutaneous FNA is warranted. EUS-guided FNA is recommended as the method of choice for diagnosis in patients with potentially resectable pancreatic cancer.     

Establishment of an organoid bank of biliary tract and pancreatic cancers and its application for personalized therapy and future treatment

Biliary tract cancers and pancreatic cancers are aggressive malignancies that are difficult to diagnose early and have a poor prognosis. Patients with inoperable biliary tract and pancreatic cancers generally receive chemotherapy regimens including gemcitabine. However, the effects of these drugs are limited, and the 5‐year survival rates of patients are very low. The newly developed three‐dimensional culture system known as “organoid culture” allows long‐term expansion of stem cells into cyst‐like structures (organoids) with properties resembling those of the original tissues. We and other groups have successfully established long‐term in vitro cultures of organoids derived from biliary tract and pancreatic cancers. Organoids derived from biliary tract and pancreatic cancers closely recapitulate the properties of the original tumors including genetic alterations, gene expression profiles, and histopathological structures. These patient‐derived cancer organoids can be applied for drug sensitivity testing, drug screening, epigenetic therapy, and differentiation‐inducing therapy to identify therapeutic agents optimal for each patient. We intend to further establish organoids derived from various cancer cases and construct an organoid bank of biliary tract and pancreatic cancers. These powerful in vitro preclinical models of refractory cancers may bridge the gap between basic research and clinical trials and allow personalized therapy for patients.