Iglesias-Garcia J, Lariño-Noia J, Dominguez-Muñoz J E
Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Minerva Gastroenterol Dietol. 2011 Jun;57(2):205-12.
Pancreatic cancer (PC) is considered as one of the malignant tumors with poorest survival rate (less than 5% 5-year survival). Despite new developments in imaging techniques, surgery and oncologic treatments, survival rate remains unchanged. In order to improve the outcome of this disease, it would be of interest the development of a screening program trying to detect small asymptomatic tumors or precursor lesions at the time when the disease is still at a curable stage. Although screening in general population is not feasible nowadays, screening programs in high risk individuals may be of help in this setting. A specific population has been defined to be screened, those with a >10-fold increased risk for developing the disease (inherited PC syndromes due to inherited gene mutations and individuals with a strong family history of PC with at least 2 first-degree relatives affected, but without a known genetic defect). Regarding the methods for screening, endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) appears to be the most accurate, mainly based in their ability to detect those small pancreatic tumors and precursor lesions (like IPMN and PanIN lesions). In these patients screening should start at the age of 45, or 15 years earlier than the earliest occurrence of PC in the family, whichever is the earlier age. Explorations should be schedule every 1 to 3 years, depending on initial findings.
胰腺癌（PC）被认为是生存率最低的恶性肿瘤之一（5年生存率低于5%）。尽管在成像技术、手术和肿瘤治疗方面有了新进展，但生存率仍未改变。为了改善这种疾病的治疗效果，开展一项筛查计划可能会很有意义，该计划试图在疾病仍处于可治愈阶段时检测出无症状的小肿瘤或前驱病变。虽然目前在普通人群中进行筛查不可行，但在高危个体中开展筛查计划可能会有所帮助。已定义了一个特定的需筛查人群，即患该病风险增加10倍以上的人群（由于遗传性基因突变导致的遗传性PC综合征以及有强烈PC家族史且至少有2名一级亲属患病但无已知遗传缺陷的个体）。关于筛查方法，内镜超声（EUS）和磁共振成像（MRI）似乎是最准确的，主要基于它们检测那些小胰腺肿瘤和前驱病变（如导管内乳头状黏液性肿瘤和胰腺上皮内瘤变病变）的能力。在这些患者中，筛查应从45岁开始，或比家族中最早发生PC的年龄提前15年开始，以较早者为准。检查应根据初始检查结果每1至3年安排一次。
