Digestive Endoscopy Unit, Catholic University of the Sacred Heart, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2010 Apr;14(4):375-85.
Early diagnosis and appropriate staging of pancreatic adenocarcinoma is of vital importance to possibly detect this otherwise lethal disease at a curable phase and to stratify patients who would benefit the most from surgical resection. The availability of endoscopic ultrasound (EUS) with its unique capability of obtaining refine images of the pancreas has represented a major breakthrough in the management of these difficult tasks. Furthermore, the ability to perform fine needle aspiration (FNA) under real time EUS guidance has offered the possibility to reach a definite diagnosis which has a major impact on the decision making process in the care of patients with both resectable and unresecectable pancreatic cancer. In parallel to the widespread importance of diagnostic EUS, the therapeutic applications of EUS are increasing and may further expand the role of this procedure in the management of pancreatic cancer. This article focuses on the current role of EUS and EUS-FNA in the diagnosis and staging of solid pancreatic lesions in different clinical scenarios, including those individuals at a high risk of developing pancreatic cancer and who may be candidates for a EUS-based screening and surveillance program. Data on the emerging therapeutic role of EUS for pancreatic cancer treatment will also be reviewed.
早期诊断和适当分期胰腺腺癌对于可能在可治愈阶段检测到这种致命疾病并对最受益于手术切除的患者进行分层至关重要。内镜超声（EUS）的出现及其获得胰腺精细图像的独特能力代表了这些困难任务管理的重大突破。此外，实时 EUS 引导下进行细针抽吸（FNA）的能力提供了明确诊断的可能性，这对可切除和不可切除胰腺癌患者的护理决策过程产生了重大影响。与诊断性 EUS 的广泛重要性并行的是，EUS 的治疗应用正在增加，并且可能进一步扩大该程序在胰腺癌管理中的作用。本文重点介绍了 EUS 和 EUS-FNA 在不同临床情况下诊断和分期实性胰腺病变的当前作用，包括那些患胰腺癌风险较高且可能是 EUS 筛查和监测计划候选者的个体。还将回顾 EUS 在胰腺癌治疗中的新兴治疗作用的数据。
