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胰腺癌筛查:面向普通临床医生的综述

Screening for pancreatic cancer: a review for general clinicians.

作者信息

Wiest Nathaniel E, Moktan Varun P, Oman Sven P, Chirilă Răzvan M

机构信息

Mayo Clinic, Department of Internal Medicine, Jacksonville, Florida.

Mayo Clinic, Simulation Center, Jacksonville, Florida.

出版信息

Rom J Intern Med. 2020 Sep 1;58(3):119-128. doi: 10.2478/rjim-2020-0009.

Abstract

Pancreatic cancer (PC) is an exceptionally lethal malignancy with increasing incidence and mortality worldwide. One of the principal challenges in the treatment of PC is that the diagnosis is usually made at a late stage when potentially curative surgical resection is no longer an option. General clinicians including internists and family physicians are well positioned to identify high-risk individuals and refer them to centers with expertise in PC screening and treatment where screening modalities can be employed. Here, we provide an up-to-date review of PC precursor lesions, epidemiology, and risk factors to empower the general clinician to recognize high-risk patients and employ risk reduction strategies. We also review current screening guidelines and modalities and preview progress that is being made to improve screening tests and biomarkers. It is our hope that this review article will empower the general clinician to understand which patients need to be screened for PC, strategies that may be used to reduce PC risk, and which screening modalities are available in order to diminish the lethality of PC.

摘要

胰腺癌(PC)是一种极其致命的恶性肿瘤,在全球范围内其发病率和死亡率都在上升。胰腺癌治疗的主要挑战之一是,通常在晚期才做出诊断,而此时潜在的根治性手术切除已不再是一种选择。包括内科医生和家庭医生在内的普通临床医生很适合识别高危个体,并将他们转诊至具备胰腺癌筛查和治疗专业知识的中心,在那里可以采用筛查方式。在此,我们提供了一份关于胰腺癌前驱病变、流行病学和危险因素的最新综述,以使普通临床医生有能力识别高危患者并采用降低风险的策略。我们还回顾了当前的筛查指南和方式,并展望了在改进筛查测试和生物标志物方面正在取得的进展。我们希望这篇综述文章能使普通临床医生了解哪些患者需要进行胰腺癌筛查、可用于降低胰腺癌风险的策略以及有哪些可用的筛查方式,从而降低胰腺癌的致死率。

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