Advances in pancreatic cancer research: Moving towards early detection
Advances in pancreatic cancer research: Moving towards early detection
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DOI：
10.3748/wjg.v20.i32.11241
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发表时间：
2014-08-28
影响因子：
4.3
通讯作者：
Yuan, Yao-Zong
中科院分区：
文献类型：
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作者：
He, Xiang-Yi;Yuan, Yao-Zong
胰腺导管腺癌（PDAC）是最致命的癌症之一。对胰腺癌生物学的理解已经取得了实质性进展，患者管理也取得了重大进展。然而，大多数患有局部晚期或转移性疾病的患者（近 80%）预后极差。对于那些患有局限于胰腺的恶性疾病的人来说，生存率更好，因为手术切除是目前唯一的治愈机会。因此，胰腺癌的早期发现可能使 PDAC 患者受益。然而，其低发病率和当前筛查策略的局限性使得早期发现变得困难。对 PDAC 发病机制了解的最新进展表明，有可能在早期阶段检测到 PDAC，甚至识别前驱病变。胰腺癌早期出现新发糖尿病可能为其早期诊断提供线索。新型循环生物标志物（包括血清学特征、自身抗体、表观遗传标志物、循环肿瘤细胞和 microRNA）鉴定的进展表明，它们可以作为未来筛查前体和早期 PDAC 的潜在工具。然而，基于有效筛查方法的适当筛查策略需要进行临床应用测试。 (C) 2014 百事登出版集团有限公司版权所有。
Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal forms of cancer. Substantial progress has been made in the understanding of the biology of pancreatic cancer, and advances in patient management have been significant. However, most patients (nearly 80%) who present with locally advanced or metastatic disease have an extremely poor prognosis. Survival is better for those with malignant disease localized to the pancreas, because surgical resection at present offers the only chance of cure. Therefore, the early detection of pancreatic cancer may benefit patients with PDAC. However, its low rate of incidence and the limitations of current screening strategies make early detection difficult. Recent advances in the understanding of the pathogenesis of PDAC suggest that it is possible to detect PDAC in early stages and even identify precursor lesions. The presence of new-onset diabetes mellitus in the early phase of pancreatic cancer may provide clues for its early diagnosis. Advances in the identification of novel circulating biomarkers including serological signatures, autoantibodies, epigenetic markers, circulating tumor cells and microRNAs suggest that they can be used as potential tools for the screening of precursors and early stage PDAC in the future. However, proper screening strategies based on effective screening methodologies need to be tested for clinical application. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.