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[早期胰腺癌]

[Early stage pancreatic cancer].

作者信息

Kahlert C, Distler M, Aust D, Gieldon L, Weitz J, Welsch T

机构信息

Klinik und Poliklinik für Viszeral‑, Thorax- und Gefäßchirurgie (VTG), Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.

Institut für Pathologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland.

出版信息

Chirurg. 2018 Apr;89(4):257-265. doi: 10.1007/s00104-017-0569-y.

Abstract

BACKGROUND

Pancreatic ductal adenocarcinoma (PDAC) represents the fourth most common cause of cancer mortality and it is expected to become the second most common cause of cancer mortality by 2020 in the USA.

OBJECTIVE

Which strategies for the detection and treatment of an early stage pancreatic adenocarcinoma and its precursor lesions are to be applied?

RESULTS

Currently, there is no effective general screening program for pancreatic cancer due to the low incidence and the lack of an accurate and inexpensive diagnostic method; however, in patients with a positive history of hereditary pancreatic cancer or in patients with a known sporadic germline mutation that is associated with an increased risk of pancreatic cancer, frequent screening is highly recommended to detect and to treat early stage PDAC. Moreover, patients with a precursor lesion for pancreatic cancer (namely a mucinous pancreatic neoplasm) should undergo an oncological pancreatic resection to prevent the development of late stage pancreatic cancer. In future, additional biomarkers from a liquid biopsy, such as circulating tumor cells, exosomes or circulating tumor DNA may improve the early detection of pancreatic cancer.

CONCLUSION

The early detection and treatment of pancreatic cancer and its precursor lesions can help to improve the dismal prognosis of this aggressive tumor type.

摘要

背景

胰腺导管腺癌(PDAC)是癌症死亡的第四大常见原因,预计到2020年在美国将成为癌症死亡的第二大常见原因。

目的

应采用哪些策略来检测和治疗早期胰腺腺癌及其前驱病变?

结果

目前,由于发病率低且缺乏准确且廉价的诊断方法,尚无有效的胰腺癌通用筛查方案;然而,对于有遗传性胰腺癌阳性病史的患者或已知存在与胰腺癌风险增加相关的散发性种系突变的患者,强烈建议进行频繁筛查以检测和治疗早期PDAC。此外,患有胰腺癌前驱病变(即黏液性胰腺肿瘤)的患者应接受肿瘤学胰腺切除术,以防止晚期胰腺癌的发生。未来,来自液体活检的其他生物标志物,如循环肿瘤细胞、外泌体或循环肿瘤DNA,可能会改善胰腺癌的早期检测。

结论

胰腺癌及其前驱病变的早期检测和治疗有助于改善这种侵袭性肿瘤类型的不良预后。

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