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筛查胰腺癌高危患者——是否到了范式转变的时候?

Screening patients at high risk for pancreatic cancer-Is it time for a paradigm shift?

机构信息

Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.

出版信息

J Surg Oncol. 2019 Oct;120(5):851-857. doi: 10.1002/jso.25616. Epub 2019 Jul 16.

Abstract

Pancreatic cancer remains leading cause of cancer-related death in the United States. Patients with familial pancreas cancer, hereditary pancreatitis, known genetic mutations, and syndromes are deemed high risk for the development of pancreas cancer. Guidelines exist to help facilitate early diagnosis and treatment and these will be reviewed. Pancreatic cancer remains a leading cause of cancer-related death in the United States. Patients with familial pancreatic cancer, hereditary pancreatitis, known genetic mutations, and syndromes are deemed high risk for the development of pancreas cancer. Guidelines have been made to help facilitate early diagnosis and treatment for these patients and these will be reviewed. The exact timing of initial screening depends not only on the individual risk factors but consists of endoscopic ultrasound and magnetic resonance cholangiopancreatography. The frequency of screening depends largely on the findings of initial imaging and the patient's clinical status. We suggest that providers make themselves knowledgeable of current screening recommendations and appropriately apply them. Further critical evaluation of ongoing research is necessary to amend these recommendations as more data and genetic testing becomes available.

摘要

在美国,胰腺癌仍然是癌症相关死亡的主要原因。患有家族性胰腺癌、遗传性胰腺炎、已知基因突变和综合征的患者被认为是胰腺癌发展的高危人群。存在有助于促进早期诊断和治疗的指南,将对这些指南进行审查。在美国,胰腺癌仍然是癌症相关死亡的主要原因。患有家族性胰腺癌、遗传性胰腺炎、已知基因突变和综合征的患者被认为是胰腺癌发展的高危人群。已经制定了指南来帮助这些患者进行早期诊断和治疗,将对这些指南进行审查。初始筛查的准确时间不仅取决于个体危险因素,还包括内镜超声和磁共振胰胆管成像。筛查的频率在很大程度上取决于初始成像的结果和患者的临床状况。我们建议提供者了解当前的筛查建议,并适当地应用这些建议。随着更多的数据和基因检测的出现,有必要对正在进行的研究进行进一步的批判性评估,以修改这些建议。

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