Li Feng, Malli Ahmad, Cruz-Monserrate Zobeida, Conwell Darwin L, Krishna Somashekar G
Division of Gastroenterology, Hepatology, and Nutrition, Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
World J Gastrointest Endosc. 2018 Jan 16;10(1):1-9. doi: 10.4253/wjge.v10.i1.1.
Increases in the quality as well as utilization of cross-sectional imaging have led to rising diagnoses of pancreatic cystic lesions (PCL). Accurate presurgical diagnosis enables appropriate triage of PCLs. Unfortunately, current diagnostic approaches have suboptimal accuracy and may lead to unnecessary surgical resections or missed diagnoses of advanced neoplasia. Additionally, early detection represents an opportunity for intervention to prevent the progression to pancreatic adenocarcinoma. Our aim for this review is to systematically review the current literature on confocal endomicroscopy and molecular biomarkers in the evaluation of PCLs. Confocal laser endomicroscopy is a novel technology that allows for real-time microscopic imaging with multiple clinical trials identifying characteristic endomicroscopy findings of various pancreatic cystic lesions. DNA-based molecular markers have also emerged as another diagnostic modality as the pattern of genetic alternations present in cyst fluid can provide both diagnostic and prognostic data. We propose that both techniques can be utilized to improve patient outcomes.
横断面成像质量及利用率的提高导致胰腺囊性病变（PCL）的诊断率上升。准确的术前诊断有助于对PCL进行适当分类。不幸的是，目前的诊断方法准确性欠佳，可能导致不必要的手术切除或晚期肿瘤的漏诊。此外，早期检测为干预提供了机会，以防止进展为胰腺腺癌。本综述的目的是系统回顾目前关于共聚焦内镜检查和分子生物标志物在PCL评估中的文献。共聚焦激光内镜检查是一项新技术，可进行实时显微镜成像，多项临床试验已确定了各种胰腺囊性病变的特征性内镜检查结果。基于DNA的分子标志物也已成为另一种诊断方式，因为囊液中存在的基因改变模式可提供诊断和预后数据。我们认为这两种技术均可用于改善患者预后。
