Department of Surgery, Klinikum rechts der Isar, Technische Universität München, 81675 München, Germany.
World J Gastroenterol. 2012 Sep 7;18(33):4474-7. doi: 10.3748/wjg.v18.i33.4474.
Despite great efforts in experimental and clinical research, the prognosis of pancreatic cancer (PC) has not changed significantly for decades. Detection of pre-invasive lesions or early-stage PC with small resectable cancers in asymptomatic individuals remains one of the most promising approaches to substantially improve the overall outcome of PC. Therefore, screening programs have been proposed to identify curable lesions especially in individuals with a familial or genetic predisposition for PC. In this regard, Canto et al recently contributed an important article comparing computed tomography, magnetic resonance imaging, and endoscopic ultrasound for the screening of 216 asymptomatic high-risk individuals (HRI). Pancreatic lesions were detected in 92 of 216 asymptomatic HRI (42.6%). The high diagnostic yield in this study raises several questions that need to be answered of which two will be discussed in detail in this commentary: First: which imaging test should be performed? Second and most importantly: what are we doing with incidentally detected pancreatic lesions? Which ones can be observed and which ones need to be resected?
尽管在实验和临床研究方面付出了巨大努力，但几十年来胰腺癌（PC）的预后并未显著改变。在无症状个体中检测到具有可切除小肿瘤的侵袭前病变或早期 PC，仍然是显著改善 PC 总体预后的最有前途的方法之一。因此，提出了筛查计划以识别可治愈的病变，特别是在具有 PC 家族或遗传易感性的个体中。在这方面，Canto 等人最近发表了一篇重要文章，比较了计算机断层扫描、磁共振成像和内镜超声在 216 名无症状高危个体（HRI）中的筛查作用。在 216 名无症状 HRI 中发现了 92 例胰腺病变（42.6%）。该研究的高诊断率提出了几个需要回答的问题，其中两个将在本评论中详细讨论：首先：应该进行哪种影像学检查？第二也是最重要的：我们如何处理偶然发现的胰腺病变？哪些可以观察，哪些需要切除？
