Dudley Beth, Brand Randall E
Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, 5200 Centre Avenue, Suite 409, Pittsburgh, PA, 15232, USA.
Curr Treat Options Gastroenterol. 2019 Dec;17(4):681-691. doi: 10.1007/s11938-019-00247-0.
Individuals who have an increased risk for pancreatic cancer (PC) due to personal or family history may benefit from surveillance of the pancreas to increase the likelihood of early detection. This review explores current indications for PC surveillance, as well as options for surveillance modality and timing, and data regarding surveillance outcomes.
Recently published data suggests that individuals undergoing surveillance who develop PC are more likely to be diagnosed with resectable disease, which improves survival. Several professional organizations have published guidelines for surveillance to help define who should have surveillance, when surveillance should be performed, and how it can be accomplished. PC surveillance should be considered for individuals with a pathogenic variant in a PC-related gene who have an affected first- or second-degree relative and for individuals in a familial pancreatic cancer family who have an affected first-degree relative. Surveillance should begin at age 50, or 10 years before the earliest age of PC diagnosis in the family. Endoscopic ultrasound (EUS) or MRI/MRCP are both reasonable surveillance options, but EUS may be better at detecting small solid changes in the pancreas. Ideally, surveillance should be performed at expert centers in conjunction with research protocols.
因个人或家族病史而患胰腺癌（PC）风险增加的个体，可能受益于胰腺监测，以提高早期检测的可能性。本综述探讨了当前PC监测的适应症、监测方式和时间选择，以及监测结果的数据。
最近发表的数据表明，接受监测且患PC的个体更有可能被诊断为可切除疾病，这可提高生存率。几个专业组织已发布监测指南，以帮助确定谁应接受监测、何时进行监测以及如何进行监测。对于在PC相关基因中有致病变异且有一级或二级亲属患病的个体，以及在家族性胰腺癌家族中有一级亲属患病的个体，应考虑进行PC监测。监测应在50岁开始，或在家族中最早诊断PC的年龄前10年开始。内镜超声（EUS）或MRI/MRCP都是合理的监测选择，但EUS可能更擅长检测胰腺的小实性变化。理想情况下，监测应在专家中心结合研究方案进行。
