Bramhall S R
University Department of Surgery, Queen Elizabeth Hospital, Birmingham, UK.
Int J Pancreatol. 1998 Apr;23(2):83-100. doi: 10.1385/IJGC:23:2:83.
It is concluded that currently there are limitations in the use of some of the proposed tests, whereas in the future, further progress in our understanding of the molecular biology of pancreatic disease and the development and application of existing techniques should have a greater impact on clinical practice.
Fifteen to 20% of patients with pancreatic cancer present with a resectable mass in the head of the pancreas, but there is a subgroup of patients for whom it is difficult to reach the correct diagnosis.
This article addresses how molecular technology can be used to aid in the diagnosis of this group of patients. The clinical and scientific literature is reviewed by accessing papers through the Medline database.
This article reviews the limitations of conventional imaging techniques and the limitations of fine needle aspiration cytology and cytological examination of pancreatic duct secretions. The molecular biology of both pancreatic cancer and chronic pancreatitis is then reviewed with emphasis on the common molecular defects seen in these diseases. The current use of molecular techniques in the examination of cytological and histological specimens, stool, blood, and pancreatic duct secretions and how this helps discriminate between benign and malignant lesions of the pancreas is addressed. Finally, the use of novel serum screening tests in groups at high risk of pancreatic cancer is discussed.
得出的结论是，目前一些提议的检测方法存在局限性，而未来我们对胰腺疾病分子生物学的理解取得进一步进展以及现有技术的开发和应用应该会对临床实践产生更大影响。
15%至20%的胰腺癌患者表现为胰腺头部有可切除肿块，但有一小部分患者难以做出正确诊断。
本文探讨了如何利用分子技术辅助诊断这组患者。通过Medline数据库检索论文，对临床和科学文献进行综述。
本文回顾了传统成像技术的局限性以及细针穿刺细胞学检查和胰管分泌物细胞学检查的局限性。接着综述了胰腺癌和慢性胰腺炎的分子生物学，重点关注这些疾病中常见的分子缺陷。阐述了分子技术目前在细胞学和组织学标本、粪便、血液及胰管分泌物检查中的应用，以及这如何有助于区分胰腺的良性和恶性病变。最后，讨论了新型血清筛查试验在胰腺癌高危人群中的应用。
