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健康筛查对胰腺癌的早期检测和预后改善有益吗?

Is health screening beneficial for early detection and prognostic improvement in pancreatic cancer?

机构信息

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Gut Liver. 2011 Jun;5(2):194-9. doi: 10.5009/gnl.2011.5.2.194. Epub 2011 Jun 24.

Abstract

BACKGROUND/AIMS: The aim of this study was to evaluate the usefulness of health screening for early detection and improved prognosis in pancreatic cancer.

METHODS

Between 1995 and 2008, 176,361 examinees visited the Health Promotion Center (HPC). Twenty patients diagnosed with pancreatic cancer were enrolled. During the same period, 40 patients were randomly selected from 2,202 patients diagnosed with pancreatic cancer at the Out Patient Clinic (OPC) for comparison.

RESULTS

Within the HPC group, 10 patients were initially suspected of having pancreatic cancer following abnormal ultrasonographic findings, and 9 patients had suspected cases following the detection of elevated serum CA 19-9. The curative resection rate was higher in the HPC group than in the OPC group (p=0.011). The median survival was longer in the HPC group than in the OPC group (p=0.000). However, there was no significant difference in the 3-year survival rate between the two groups. Asymptomatic patients (n=6/20) in the HPC group showed better curative resection and survival rates than symptomatic patients. However, the difference was not statistically significant.

CONCLUSIONS

Health screening is somewhat helpful for improving the curative resection rate and median survival of patients with pancreatic cancer detected by screening tests. However, the benefit of this method in improving long-term survival is limited by how early the cancer is detected.

摘要

背景/目的:本研究旨在评估健康筛查在胰腺癌早期发现和改善预后方面的作用。

方法

1995 年至 2008 年间,共有 176361 名受检者到健康促进中心(HPC)进行体检。在此期间,共诊断出 20 例胰腺癌患者,将其纳入研究。同期,我们从门诊(OPC)就诊的 2202 例胰腺癌患者中随机抽取 40 例作为对照组。

结果

HPC 组中,有 10 例患者因超声异常而初步怀疑患有胰腺癌,9 例患者因血清 CA 19-9 升高而怀疑患有胰腺癌。HPC 组的根治性切除率高于 OPC 组(p=0.011)。HPC 组的中位生存期长于 OPC 组(p=0.000)。然而,两组的 3 年生存率无显著差异。HPC 组中无症状患者(n=6/20)的根治性切除率和生存率均优于有症状患者,但差异无统计学意义。

结论

健康筛查对提高筛查试验检出的胰腺癌患者的根治性切除率和中位生存期有一定帮助。但通过该方法提高长期生存率的获益程度取决于癌症的早期检出程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1d8/3140665/f056a3370627/gnl-5-194-g001.jpg

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