췌장암 조기 진단을 위한 선별 검사
Screening of Pancreatic Cancer for Early Diagnosis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Over 80% of patients with pancreatic ductal adenocarcinomas (PDAs) present with symptomatic, surgically unresectable disease. If a “stage shift” from the current 20% proportion of resectability to early detection could be achieved, this would greatly improve the survival of patients with this generally dismal disease. Although the goal of early detection is laudable, the relatively low prevalence of PDA renders general population screening unfeasible. To avoid the perils of overdiagnosis and to focus early detection efforts on individuals deemed to be at higher-than-average risk, we need to define such subsets of individuals, such as kindred of existing patients and those with precursor cystic lesions, chronic pancreatitis, and new-onset diabetes. The next step is to determine when and how often to monitor at-risk individuals and the diagnostic modalities that will be employed in the surveillance. Enormous challenges remain in terms of validated blood-based biomarkers, imaging modalities, and when and how often surveillance.
Abstract
Over 80% of patients with pancreatic ductal adenocarcinomas (PDAs) present with symptomatic, surgically unresectable disease. If a “stage shift” from the current 20% proportion of resectability to early detection could be achieved, this would greatly improve the survival of patients with this generally dismal disease. Although the goal of early detection is laudable, the relatively low prevalence of PDA renders general population screening unfeasible. To avoid the perils of overdiagnosis and to focus early detection efforts on individuals deemed to be at higher-than-average risk, we need to define such subsets of individuals, such as kindred of existing patients and those with precursor cystic lesions, chronic pancreatitis, and new-onset diabetes. The next step is to determine when and how often to monitor at-risk individuals and the diagnostic modalities that will be employed in the surveillance. Enormous challenges remain in terms of validated blood-based biomarkers, imaging modalities, and when and how often surveillance.
참고문헌 (21)
- Wood LD, "Genetics of familial and sporadic pancreatic cancer", Gastroenterology, 156, pp.2041~2055 (2019)
- Vasen H, "Benefit of surveillance for pancreatic cancer in high-risk individuals : outcome of long-term prospective follow-up studies from three European Expert Centers", J Clin Oncol, 34, pp.2010~2019 (2016)
- Canto MI, "Risk of neoplastic progression in individuals at high risk for pancreatic cancer undergoing long-term surveillance", Gastroenterology, 155, pp.740~751 (2018)
- Raimondi S, "Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection", Best Pract Res Clin Gastroenterol, 24, pp.349~358 (2010)
- Kirkegård J, "Chronic pancreatitis and pancreatic cancer risk : a systematic review and meta-analysis", Am J Gastroenterol, 112, pp.1366~1372 (2017)
- Tanaka M, "Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas", Pancreatology, 17, pp.738~753 (2017)
- Tanaka M, "Intraductal papillary mucinous neoplasm of the pancreas as the main focus for early detection of pancreatic adenocarcinoma", Pancreas, 47, pp.544~550 (2018)
- Vege SS, "American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts", Gastroenterology, 148, pp.819~ (2015)
- Megibow AJ, "Management of incidental pancreatic cysts : a white paper of the ACR Incidental Findings Committee", J Am Coll Radiol, 14, pp.911~923 (2017)
- Elta GH, "ACG clinical guideline : diagnosis and management of pancreatic cysts", Am J Gastroenterol, 113, pp.464~479 (2018)
- European Study Group on Cystic Tumours of the Pancreas, "European evidence-based guidelines on pancreatic cystic neoplasms", Gut, 67, pp.789~804 (2018)
- Sharma A, "Fasting blood glucose levels provide estimate of duration and progression of pancreatic cancer before diagnosis", Gastroenterology, 155, pp.490~500 (2018)
- Mueller AM, "The potential of glycemic control and body weight change as early markers for pancreatic cancer in patients with long-standing diabetes mellitus : a case-control study", Pancreas, 47, pp.807~815 (2018)
- Pannala R, "Prevalence and clinical profile of pancreatic cancer-associated diabetes mellitus", Gastroenterology, 134, pp.981~987 (2008)
- Singhi AD, "Early detection of pancreatic cancer : opportunities and challenges", Gastroenterology, 156, pp.2024~2040 (2019)
- Sharma A, "Model to determine risk of pancreatic cancer in patients with new-onset diabetes", Gastroenterology, 155, pp.730.e3~739.e3 (2018)
- Mellby LD, "Serum biomarker signature-based liquid biopsy for diagnosis of early-stage pancreatic cancer", J Clin Oncol, 36, pp.2887~2894 (2018)
- Canto MI, "Frequent detection of pancreatic lesions in asymptomatic high-risk individuals", Gastroenterology, 142, pp.796~ (2012)
- Sah RP, "Phases of metabolic and soft tissue changes in months preceding a diagnosis of pancreatic ductal adenocarcinoma", Gastroenterology, 156, pp.1742~1752 (2019)
- Alauddin MM, "Current and future trends in early detection of pancreatic cancer : molecular targets and PET probes", Curr Med Chem, 22, pp.3370~3389 (2015)
- England CG, "Molecular imaging of pancreatic cancer with antibodies", Mol Pharm, 13, pp.8~24 (2016)