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鉴定胰腺癌高危种系变异:共同特征及对筛查指南的潜在指导意义。

Identification of high-risk germline variants for the development of pancreatic cancer: Common characteristics and potential guidance to screening guidelines.

机构信息

Division of Surgical Oncology, Department of Surgery, Northwestern Medicine Regional Medical Group, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Division of Surgical Oncology, Department of Surgery, Northwestern Medicine Regional Medical Group, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.

出版信息

Pancreatology. 2022 Sep;22(6):719-729. doi: 10.1016/j.pan.2022.05.005. Epub 2022 May 27.

Abstract

Pancreatic cancer (PC) is a product of a variety of environmental and genetic factors. Recent work has highlighted the influence of hereditary syndromes on pancreatic cancer incidence. The purpose of this review is to identify the high-risk syndromes, common variants, and risks associated with PC. The study also elucidates common characteristics of patients with these mutations, which is used to recommend potential changes to current screening protocols for greater screening efficacy. We analyzed 8 syndromes and their respective variants: Hereditary Breast and Ovarian Cancer (BRCA1/2), Familial Atypical Multiple Mole Melanoma Syndrome (CDKN2A), Peutz-Jeghers Syndrome (STK11), Lynch Syndrome (PMS2, MLH1, MSH2, MSH6, EPCAM), Ataxia Telangiectasia (ATM), Li-Fraumeni Syndrome (TP53), Fanconi Anemia (PALB2), and Hereditary Pancreatitis (PRSS1, SPINK1, CFTR). Of 587 studies evaluated, 79 studies fit into our inclusion criteria. Information from each study was analyzed to draw conclusions on these variants as well as their association with pancreatic cancer. Information from this review is intended to improve precision medicine and improve criteria for screening.

摘要

胰腺癌(PC)是多种环境和遗传因素的产物。最近的研究强调了遗传综合征对胰腺癌发病率的影响。本综述的目的是确定高危综合征、常见变异体以及与 PC 相关的风险。该研究还阐明了具有这些突变的患者的常见特征,这有助于推荐对当前筛查方案的潜在改变,以提高筛查效果。我们分析了 8 种综合征及其各自的变体:遗传性乳腺癌和卵巢癌(BRCA1/2)、家族性非典型多发性痣黑色素瘤综合征(CDKN2A)、Peutz-Jeghers 综合征(STK11)、林奇综合征(PMS2、MLH1、MSH2、MSH6、EPCAM)、共济失调毛细血管扩张症(ATM)、Li-Fraumeni 综合征(TP53)、范可尼贫血(PALB2)和遗传性胰腺炎(PRSS1、SPINK1、CFTR)。在评估的 587 项研究中,有 79 项符合我们的纳入标准。对每项研究的信息进行分析,得出这些变体及其与胰腺癌的关联的结论。本综述的信息旨在提高精准医学水平,并改善筛查标准。

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