Khokhar Asim S, Sher Amna F, Schattner Mark
Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Stony Brook University Hospital, Stony Brook, NY, USA.
Chin Clin Oncol. 2017 Dec;6(6):63. doi: 10.21037/cco.2017.12.02.
Pancreatic cancer accounts for approximately 3% of all cancers in US, and is the fourth leading cause of mortality in both men and women. It is a silent killer due to lack of early symptoms and the majority of patients present at advanced stage at the time of initial diagnosis. Only 15-20% of patients are candidates for curative resection and even then, the 5-year survival rates range from 10-25%. Despite recent advances in the treatment of advanced pancreatic cancer, the prognosis remains grim with 5-year overall survival (OS) of approximately 10%. Early detection is key for improving patient outcomes in this lethal disease. Contributing to the difficulty in the diagnosis and management is the anatomic location of the pancreas within the abdomen (retroperitoneal location and being adjacent to hollow viscus, solid organs and major vessels), and suboptimal response to systemic chemotherapy. Multimodality imaging (pancreatic protocol CT and MRI/MRCP) is often used for the diagnosis and staging of pancreatic adenocarcinoma. Interventional endoscopy is a relatively new field, and with Endoscopic techniques becoming more advanced, their role in diagnosis and management of pancreatic cancer is expanding rapidly. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are the two main modalities used in cases of pancreatic neoplasms.
胰腺癌约占美国所有癌症的3%，是男性和女性死亡的第四大主要原因。由于缺乏早期症状，它是一种无声杀手，大多数患者在初次诊断时已处于晚期。只有15%-20%的患者适合进行根治性切除，即便如此，5年生存率也在10%-25%之间。尽管晚期胰腺癌的治疗最近取得了进展，但预后仍然严峻，5年总生存率约为10%。早期检测是改善这种致命疾病患者预后的关键。胰腺在腹腔内的解剖位置（腹膜后位置且与中空脏器、实体器官和主要血管相邻）以及对全身化疗的反应欠佳，导致了诊断和管理的困难。多模态成像（胰腺方案CT和MRI/MRCP）常用于胰腺腺癌的诊断和分期。介入性内镜检查是一个相对较新的领域，随着内镜技术变得更加先进，它们在胰腺癌诊断和管理中的作用正在迅速扩大。内镜逆行胰胆管造影（ERCP）和内镜超声（EUS）是胰腺肿瘤病例中使用的两种主要方式。
