The Sol Goldman Pancreatic Cancer Research Center, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Pathology, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Expert Rev Gastroenterol Hepatol. 2023 Jan-Jun;17(6):555-574. doi: 10.1080/17474124.2023.2217354. Epub 2023 Jul 3.
Most patients with pancreatic cancer present with advanced stage, incurable disease. However, patients with high-grade precancerous lesions and many patients with low-stage disease can be cured with surgery, suggesting that early detection has the potential to improve survival. While serum CA19.9 has been a long-standing biomarker used for pancreatic cancer disease monitoring, its low sensitivity and poor specificity have driven investigators to hunt for better diagnostic markers.
This review will cover recent advances in genetics, proteomics, imaging, and artificial intelligence, which offer opportunities for the early detection of curable pancreatic neoplasms.
From exosomes, to circulating tumor DNA, to subtle changes on imaging, we know much more now about the biology and clinical manifestations of early pancreatic neoplasia than we did just five years ago. The overriding challenge, however, remains the development of a practical approach to screen for a relatively rare, but deadly, disease that is often treated with complex surgery. It is our hope that future advances will bring us closer to an effective and financially sound approach for the early detection of pancreatic cancer and its precursors.
大多数胰腺癌患者就诊时已处于晚期,无法治愈。然而,高等级癌前病变患者和许多低分期疾病患者可以通过手术治愈,这表明早期检测有可能改善生存。虽然血清 CA19.9 一直是用于胰腺癌疾病监测的长期生物标志物,但由于其敏感性低和特异性差,研究人员一直在寻找更好的诊断标志物。
本文综述了遗传学、蛋白质组学、影像学和人工智能方面的最新进展,这些进展为可治愈的胰腺肿瘤的早期检测提供了机会。
从外泌体、循环肿瘤 DNA 到影像学上的细微变化,我们现在对早期胰腺肿瘤的生物学和临床表现的了解比五年前多得多。然而,最大的挑战仍然是开发一种实用的方法来筛查相对罕见但致命的疾病,这种疾病通常需要复杂的手术治疗。我们希望未来的进展能够使我们更接近一种有效的、经济合理的方法,用于早期发现胰腺癌及其前体。