Internal Medicine and Gastroenterology, Caritasklinikum St. Theresia, Saarbruecken, Germany.
Internal Medicine, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.
Oncol Res Treat. 2023;46(6):259-267. doi: 10.1159/000530790. Epub 2023 Apr 25.
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy that is increasingly common. Screening for pancreatic cancer is not well established but might increase the chance of detection in early stages.
We conducted a literature search to summarize current recommendations and to give an overview of patient groups that may benefit from screening. In the general population, screening is not recommended because the low prevalence of PDAC renders any diagnostic tests non-predictive and because there is no direct evidence that links early diagnosis to improved survival. To date, novel approaches like liquid biopsies and molecular markers are not yet able to improve screening in unselected individuals but offer promising potential. Screening efficiency increases considerably with increasing pretest probability. Therefore, the best way to improve early diagnosis is identifying high-risk individuals.
There are well-defined populations with distinct genetic alterations with an increased risk for pancreatic cancer. Those may be screened with common diagnostic methods. In addition, new-onset diabetes is increasingly recognized as an early symptom, especially in elderly patients with weight loss.
胰腺导管腺癌（PDAC）是一种侵袭性恶性肿瘤，其发病率日益增高。目前尚未建立起完善的胰腺癌筛查体系，但筛查可能会增加早期发现的机会。
我们进行了文献检索，以总结当前的建议，并概述可能从筛查中获益的患者群体。在一般人群中，不推荐进行筛查，因为 PDAC 的低患病率使得任何诊断检测都缺乏预测性，而且没有直接证据表明早期诊断与生存改善相关。迄今为止，液体活检和分子标志物等新方法尚不能提高未选择个体的筛查效果，但具有很大的应用潜力。随着术前概率的增加，筛查效率会大大提高。因此，提高早期诊断的最佳方法是识别高危个体。
有明确的具有更高胰腺癌风险的特定基因突变人群，可采用常规诊断方法进行筛查。此外，新发糖尿病越来越被认为是一种早期症状，尤其是在伴有体重减轻的老年患者中。
