Better Biomarkers for Pancreatic Diseases.
Better Biomarkers for Pancreatic Diseases.
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更好的胰腺疾病生物标志物。
DOI：
10.1097/mpa.0000000000000550
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发表时间：
2015
期刊：
影响因子：
2.9
通讯作者：
Whitcomb,DavidC
中科院分区：
文献类型：
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作者：
Whitcomb,DavidC
医生们很难评估人体的胰腺——一个隐藏在胃和肠后面的腹膜后空间的器官，在那里它是无法进行身体检查的。胰腺疾病在早期阶段仍然难以发现，并且具有复杂和高度可变的临床病程。外分泌胰腺的主要非恶性慢性疾病大致可分为4类。感染性胰腺炎发生但不常见，创伤性损伤可引发胰腺炎，但占少数病例。众所周知，胰腺的单基因孟德尔疾病包括囊性纤维化、遗传性胰腺炎和家族性胰腺炎，但这些疾病加起来只占疾病负担的一小部分。大多数外分泌胰腺疾病属于第四类。它们包括在某些个体中随机出现的多发性、进行性、复杂疾病，表现为复发性急性胰腺炎（RAP）、慢性胰腺炎（CP）或胰腺肿瘤。胰腺肿瘤通常独立于临床明显的炎症而发生，由于其发展也出乎意料，因此在晚期才被发现。因此，复杂疾病代表了大多数胰腺疾病；其发生的突发性、临床病程的不可预测性以及缺乏有效的靶向治疗给临床评价和管理带来了挑战。
Physicians struggle to evaluate the human pancreas—an organ tucked in the retroperitoneal space behind the stomach and intestines where it is inaccessible to physical examination. Pancreatic disorders remain difficult to detect at early stages and have complex and highly variable clinical courses. The major nonmalignant chronic diseases of the exocrine pancreas can be broadly divided into 4 categories. Infectious pancreatitis occurs but is uncommon, and traumatic injury can trigger pancreatitis but accounts for a minority of cases. Monogenetic Mendelian disorders of the pancreas including cystic fibrosis, hereditary pancreatitis, and familial pancreatitis are well known, but together, these account for a fraction of the burden of disease. The majority of exocrine pancreatic diseases fall into the fourth category. They include multiple, progressive, complex disorders that appear randomly in some individuals, presenting as recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), or pancreatic neoplasms. Pancreatic neoplasms typically occur independent of clinically evident inflammation, and detection occurs at late stages because their development is also unexpected. Thus, complex disorders represent the majority of pancreatic disease; their unexpected occurrence, unpredictable clinical course, and paucity of effective targeted treatment make clinical evaluation and management challenging.