Frequent detection of pancreatic lesions in asymptomatic high-risk individuals.
Frequent detection of pancreatic lesions in asymptomatic high-risk individuals.
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DOI：
10.1053/j.gastro.2012.01.005
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发表时间：
2012-04
期刊：
影响因子：
29.4
通讯作者：
American Cancer of the Pancreas Screening (CAPS) Consortium
中科院分区：
文献类型：
--
作者：
Canto MI;Hruban RH;Fishman EK;Kamel IR;Schulick R;Zhang Z;Topazian M;Takahashi N;Fletcher J;Petersen G;Klein AP;Axilbund J;Griffin C;Syngal S;Saltzman JR;Mortele KJ;Lee J;Tamm E;Vikram R;Bhosale P;Margolis D;Farrell J;Goggins M;American Cancer of the Pancreas Screening (CAPS) Consortium
有胰腺癌家族史或易感生殖系突变的患者患胰腺癌的风险增加。筛查可以发现可治愈的非侵袭性胰腺肿瘤，但最佳成像方法尚不清楚。我们使用3种影像学检查来筛查无症状的高危个体（HRI），以确定胰腺异常的基线患病率和特征。我们使用计算机断层扫描（CT）、磁共振成像（MRI）和超声内镜（EUS）在美国5个学术医学中心对225例无症状成人HRI进行了一次筛查。我们以盲法、独立方式比较结果。216例HRI中有92例（42%）通过任何成像方式发现至少有1个胰腺肿块（84个囊性，3个实性）或扩张的胰管（n=5）。在84例HRI囊肿中，51例（60.7%）在多个位置有多处病变，通常较小（平均0.55 cm，范围2-39 mm）。胰腺病变的患病率随着年龄的增长而增加;在50岁以下的受试者中检测到14%，50-59岁的受试者中检测到34%，60-69岁的受试者中检测到53%（P<.0001）。CT、MRI和EUS分别在11%、33.3%和42.6%的HRI中检测到胰腺异常。在这些异常中，在85例HRI中确定了确诊或疑似肿瘤（82例导管内乳头状粘液性肿瘤[IPMN]和3例胰腺内分泌肿瘤）。5例接受胰腺切除术的HRI中有3例在<3 cm的IPMN和多发性上皮内瘤变中具有高度异型增生。无症状性HRI的筛查经常发现小的胰腺囊肿，包括可治愈的、非侵袭性的高级别肿瘤。EUS和MRI对胰腺病变的检出优于CT。
The risk of pancreatic cancer is increased in patients with a strong family history of pancreatic cancer or a predisposing germline mutation. Screening can detect curable, non-invasive pancreatic neoplasms, but the optimal imaging approach is not known. We determined the baseline prevalence and characteristics of pancreatic abnormalities using 3 imaging tests to screen asymptomatic, high-risk individuals (HRI). We screened 225 asymptomatic adult HRI at 5 academic US medical centers once, using computed tomography (CT), magnetic resonance imaging (MRI), and endoscopic ultrasonography (EUS). We compared results in a blinded, independent fashion. Ninety-two of 216 HRI (42%) were found to have at least 1 pancreatic mass (84 cystic, 3 solid) or a dilated pancreatic duct (n=5) by any of the imaging modalities. Fifty-one of the 84 HRI with a cyst (60.7%) had multiple lesions, typically small (mean 0.55 cm, range 2–39 mm), in multiple locations. The prevalence of pancreatic lesions increased with age; they were detected in 14% of subjects <50 years old, 34% of subjects 50–59 years old, and 53% of subjects 60–69 years old (P<.0001). CT, MRI, and EUS detected a pancreatic abnormality in 11%, 33.3%, and 42.6% of the HRI, respectively. Among these abnormalities, proven or suspected neoplasms were identified in 85 HRI (82 intraductal papillary mucinous neoplasms [IPMN] and 3 pancreatic endocrine tumors). Three of 5 HRI who underwent pancreatic resection had high-grade dysplasia in <3 cm IPMNs and in multiple intraepithelial neoplasias. Screening of asymptomatic HRI frequently detects small pancreatic cysts, including curable, non-invasive high-grade neoplasms. EUS and MRI detect pancreatic lesions better than CT.
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DOI：
10.2214/ajr.07.3340
发表时间：
2008-09
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Laffan TA;Horton KM;Klein AP;Berlanstein B;Siegelman SS;Kawamoto S;Johnson PT;Fishman EK;Hruban RH
通讯作者：
Hruban RH
影响因子：
9.8
作者：
Poley, J. W.;Kluijt, I.;Bruno, M. J.
通讯作者：
Bruno, M. J.
影响因子：
3.8
作者：
Petersen, GM;de Andrade, M;Kiein, AP
通讯作者：
Kiein, AP
DOI：
10.1158/1078-0432.ccr-09-0004
发表时间：
2009-12-15
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Shi C;Klein AP;Goggins M;Maitra A;Canto M;Ali S;Schulick R;Palmisano E;Hruban RH
通讯作者：
Hruban RH
影响因子：
12.6
作者：
de Jong, Koen;Nio, C. Yung;Bruno, Marco J.
通讯作者：
Bruno, Marco J.