Departments of Surgery.
Gastroenterology, Ronald Reagan UCLA Medical Center, Santa Monica.
Pancreas. 2020 Oct;49(9):1141-1152. doi: 10.1097/MPA.0000000000001662.
Pancreatic cancer is the fourth leading cause of cancer death in the United States. Pancreatic cancer presents dismal clinical outcomes in patients, and the incidence of pancreatic cancer has continuously increased to likely become the second most common cause of cancer-related deaths by as early as 2030. One of main reasons for the high mortality rate of pancreatic cancer is the lack of tools for early-stage detection. Current practice in detecting and monitoring therapeutic response in pancreatic cancer relies on imaging analysis and invasive endoscopic examination. Liquid biopsy-based analysis of genetic alterations in biofluids has become a fundamental component in the diagnosis and management of cancers. There is an urgent need for scientific and technological advancement to detect pancreatic cancer early and to develop effective therapies. The development of a highly sensitive and specific liquid biopsy tool will require extensive understanding on the characteristics of circulating tumor DNA in biofluids. Here, we have reviewed the current status of liquid biopsy in detecting and monitoring pancreatic cancers and our understanding of circulating tumor DNA that should be considered for the development of a liquid biopsy tool, which will greatly aid in the diagnosis and healthcare of people at risk.
在美国,胰腺癌是第四大癌症死亡原因。胰腺癌患者的临床预后较差,而且其发病率不断上升,到 2030 年之前,胰腺癌很可能成为癌症相关死亡的第二大常见原因。胰腺癌死亡率高的主要原因之一是缺乏早期检测工具。目前,在胰腺癌的检测和监测治疗反应方面主要依赖于影像学分析和有创性内镜检查。基于生物液中遗传改变的液体活检分析已成为癌症诊断和管理的基本组成部分。非常需要科学和技术的进步来早期发现胰腺癌并开发有效的治疗方法。开发一种高灵敏度和特异性的液体活检工具需要广泛了解生物液中循环肿瘤 DNA 的特征。在这里,我们综述了液体活检在检测和监测胰腺癌方面的现状,以及我们对循环肿瘤 DNA 的理解,这些都应该被考虑用于开发液体活检工具,这将极大地有助于高危人群的诊断和医疗保健。