Vargas Alejandra, Dutta Priyata, Carpenter Eileen S, Machicado Jorge D
Department of Medicine, Eastern Virginia Medical School, Norfolk, VA 23510, USA.
Department of Medicine, Trinity Health, Ann Arbor, MI 48197, USA.
Diagnostics (Basel). 2024 Mar 6;14(5):564. doi: 10.3390/diagnostics14050564.
Pancreatic cancer is on the rise and expected to become the second leading cause of cancer-related death by 2030. Up to a one-fifth of pancreatic cancers may arise from mucinous pancreatic cysts, which are frequently present in the general population. Currently, surgical resection is the only curative approach for pancreatic cancer and its cystic precursors. However, only a dismal proportion of patients are eligible for surgery. Therefore, novel treatment approaches to treat pancreatic cancer and precancerous pancreatic cysts are needed. Endoscopic ultrasound (EUS)-guided ablation is an emerging minimally invasive method to treat pancreatic cancer and premalignant pancreatic cysts. Different ablative modalities have been used including alcohol, chemotherapy agents, and radiofrequency ablation. Cumulative data over the past two decades have shown that endoscopic ablation of mucinous pancreatic cysts can lead to cyst resolution in a significant proportion of the treated cysts. Furthermore, novel data are emerging about the ability to endoscopically ablate early and locally advanced pancreatic cancer. In this review, we aim to summarize the available data on the efficacy and safety of the different EUS-ablation modalities for the management of premalignant pancreatic cysts and pancreatic cancer.
胰腺癌的发病率正在上升，预计到2030年将成为癌症相关死亡的第二大主要原因。高达五分之一的胰腺癌可能起源于胰腺黏液性囊肿，这种囊肿在普通人群中很常见。目前，手术切除是治疗胰腺癌及其囊性前驱病变的唯一治愈方法。然而，只有少部分患者适合手术。因此，需要新的治疗方法来治疗胰腺癌和癌前胰腺囊肿。内镜超声（EUS）引导下的消融是一种新兴的微创方法，用于治疗胰腺癌和癌前胰腺囊肿。已使用了不同的消融方式，包括酒精、化疗药物和射频消融。过去二十年的累积数据表明，内镜下消融胰腺黏液性囊肿可使相当一部分接受治疗的囊肿消退。此外，关于内镜下消融早期和局部晚期胰腺癌的能力也有新的数据出现。在本综述中，我们旨在总结不同EUS消融方式治疗癌前胰腺囊肿和胰腺癌的疗效及安全性的现有数据。
