Pezzilli Raffaele, Caccialanza Riccardo, Capurso Gabriele, Brunetti Oronzo, Milella Michele, Falconi Massimo
Gastroenterology Unit, San Carlo Hospital, Via P. Petrone, 85100 Potenza, Italy.
Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy.
Cancers (Basel). 2020 Jan 22;12(2):275. doi: 10.3390/cancers12020275.
Pancreatic cancer is an aggressive malignancy and the seventh leading cause of global cancer deaths in industrialised countries. More than 80% of patients suffer from significant weight loss at diagnosis and over time tend to develop severe cachexia. A major cause of weight loss is malnutrition. Patients may experience pancreatic exocrine insufficiency (PEI) before diagnosis, during nonsurgical treatment, and/or following surgery. PEI is difficult to diagnose because testing is cumbersome. Consequently, PEI is often detected clinically, especially in non-specialised centres, and treated empirically. In this position paper, we review the current literature on nutritional support and pancreatic enzyme replacement therapy (PERT) in patients with operable and non-operable pancreatic cancer. To increase awareness on the importance of PERT in pancreatic patients, we provide recommendations based on literature evidence, and when data were lacking, based on our own clinical experience.
胰腺癌是一种侵袭性恶性肿瘤，在工业化国家中是全球癌症死亡的第七大主要原因。超过80%的患者在确诊时体重显著下降，并且随着时间推移往往会发展为严重恶病质。体重减轻的一个主要原因是营养不良。患者在诊断前、非手术治疗期间和/或手术后可能会出现胰腺外分泌功能不全（PEI）。PEI难以诊断，因为检测过程繁琐。因此，PEI通常是在临床上被发现，尤其是在非专科中心，并进行经验性治疗。在本立场文件中，我们回顾了关于可手术和不可手术胰腺癌患者营养支持和胰酶替代疗法（PERT）的当前文献。为了提高对PERT在胰腺疾病患者中重要性的认识，我们根据文献证据提供建议，当缺乏数据时，则根据我们自己的临床经验提供建议。
