散发性胰腺癌的早期检测:变革之时。

Early detection of sporadic pancreatic cancer: time for change.

作者信息

Frič Přemysl, Šedo Aleksi, Škrha Jan, Bušek Petr, Laclav Martin, Škrha Pavel, Zavoral Miroslav

机构信息

aDepartment of Medicine/Gastroenterology, Military University Hospital bInstitute of Biochemistry and Experimental Oncology cLaboratory of Endocrinology and Metabolism, General University Hospital, First Faculty of Medicine dSecond Department of Medicine, University Hospital, Third Faculty of Medicine, Charles University, Prague, Czech Republic.

出版信息

Eur J Gastroenterol Hepatol. 2017 Aug;29(8):885-891. doi: 10.1097/MEG.0000000000000904.

Abstract

Sporadic pancreatic cancer amounts to ∼90% of all pancreatic cancers. It is a gloomy depressive disease and the most recalcitrant malignancy, with a very low 5-year survival (3-6%). At present, diagnostic methods are commonly applied, as used half a century ago, after the appearance of local and systemic symptoms (abdominal and back pain, cholestasis, painless jaundice, fatigue, anorexia, weight loss, anemia, peripheral phlebitis, and cachexia). Unfortunately, these symptoms are harbingers of an advanced disease. The subsequent imaging methods may offer additional information on the location, size, and morphology of the lesion, but they do not influence the prognosis. Radical surgery may be offered to 15-20% of patients. The relapses after surgery are frequent and chemotherapy may be palliative. Preventive programs represent the only possibility of improvement. We propose the first multistep and multidisciplinary preventive program for early detection of sporadic pancreatic cancer for the differential identification of average-risk patients who probably have the disease from those who do not.

摘要

散发性胰腺癌约占所有胰腺癌的90%。它是一种令人沮丧的难治性疾病,也是最难治疗的恶性肿瘤,5年生存率极低(3%-6%)。目前,诊断方法与半个世纪前一样,在出现局部和全身症状(腹痛、背痛、胆汁淤积、无痛性黄疸、疲劳、厌食、体重减轻、贫血、外周静脉炎和恶病质)后才普遍应用。不幸的是,这些症状是疾病晚期的先兆。随后的成像方法可能会提供有关病变位置、大小和形态的额外信息,但它们不会影响预后。15%-20%的患者可能会接受根治性手术。术后复发很常见,化疗可能只是姑息性的。预防计划是改善病情的唯一可能性。我们提出了首个多步骤、多学科的散发性胰腺癌早期检测预防计划,用于区分可能患有该疾病的平均风险患者和未患病的患者。

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