Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
Division of Genetic Medicine Promotion, Shizuoka Cancer Center, Shizuoka, Japan.
Gut Liver. 2020 Jan 15;14(1):30-36. doi: 10.5009/gnl18491.
The number of patients with pancreatic cancer (PC) is currently increasing in both Korea and Japan. The 5-year survival rate of patients with PC 13.0%; however, resection with minimal invasion (tumor size: ≤10 mm) increases the 5-year survival rate to 80%. For this reason, early detection is essential, but most patients with early-stage PC are asymptomatic. Early detection of PC has been reported to require screening of high-risk individuals (HRIs), such as those with a family history of PC, inherited cancer syndromes, intraductal papillary mucinous neoplasm, or chronic pancreatitis. Studies on screening of these HRIs have confirmed a significantly better prognosis among patients with PC who were screened than for patients with PC who were not screened. However, to date in Japan, most patients with early-stage PC diagnosed in routine clinics were not diagnosed during annual health checks or by surveillance; rather, PC was detected in these patients by incidental findings during examinations for other diseases. We need to increase the precision of the PC screening and diagnostic processes by introducing new technologies, and we need to pay greater attention to incidental clinical findings.
目前,韩国和日本的胰腺癌(PC)患者人数都在增加。PC 患者的 5 年生存率为 13.0%;然而,微创切除(肿瘤大小:≤10mm)可将 5 年生存率提高至 80%。因此,早期检测至关重要,但大多数早期 PC 患者没有症状。据报道,早期 PC 的检测需要对高危个体(HRIs)进行筛查,例如有 PC 家族史、遗传性癌症综合征、导管内乳头状黏液瘤或慢性胰腺炎的个体。对这些 HRIs 的筛查研究证实,筛查患者的 PC 预后明显好于未筛查患者的 PC。然而,迄今为止,在日本,在常规诊所诊断出的大多数早期 PC 患者并非在年度健康检查或监测中诊断出,而是在对其他疾病进行检查时偶然发现的。我们需要通过引入新技术来提高 PC 筛查和诊断过程的准确性,并且需要更加关注偶然的临床发现。