Gut:已有影像学方法仍不能有效及时筛检胰腺癌!

2021-04-09 MedSci原创 MedSci原创

评估了对遗传易感高危人群进行胰腺癌监测的长期收益

胰腺癌是一种高致死率的癌症,需要手术联合系统化疗才有望获得长期存活的一线生机。不幸地是,大部分患者确诊时已错失手术机会。通过早期筛查或可降低胰腺癌的死亡率,但当下缺乏有效的生物标志物,仍依赖于影像学检查。

本研究旨在评估对遗传易感高危人群进行胰腺癌监测的长期收益。

2006年至2019年,研究人员回顾性的招募了估计胰腺导管腺癌(PDAC)终生患病风险≥10%的无症状个体,每年进行一次随时,每次随访时予以内窥镜超声检查(EUS)和MRI/胆管胰成像术(MRI / MRCP)检查。

总体上,共招募了366位个体,包括201位家族性胰腺癌(FPC)患者的无突变亲属和165位PDAC易感基因突变携带者。平均54岁,平均随访了53个月。

胰腺癌累积发生率

10位个体罹患PDAC,其中4位是有症状的间隔癌,6例成功进行了手术切除。突变携带者的PDAC累积发生率为9.3%,FPC亲属的累积PDAC发生率为0%(p<0.001)。中位PDAC存活期为18个月。

检出胰腺病变的敏感性

17位(4.6%)个体进行了手术,病理结果提示 6例PDAC(3例T1N0M0期)、7例低级别癌前病变、2例神经内分泌瘤(<2 cm)、1例自身免疫性胰腺炎和1例未发现病变

无手术并发症。EUS对实体病变的检出率高于MRI/MRCP(100% vs 22%,p<0.001),但对囊性病变的检出率低于MRI/MRCP(42% vs 83%,p<0.001)。

综上,对于已知高风险突变携带者,定期随访PDAC的诊断率相对较高,但在不携带突变的FPC亲属中未发现PDAC。尽管同时使用了两种成像方式,但EUS的表现优于MRI/MRCP,因此及时识别可切除的病变被证明具有挑战性。总体而言,通过影像学手段监测产生的效果欠佳,因此,我们还是需要更敏感的诊断标志物,包括生物标志物

原始出处:

Overbeek KA, Levink IJM, Koopmann BDM, et al Long-term yield of pancreatic cancer surveillance in high-risk individuals Gut Published Online First: 05 April 2021. doi: 10.1136/gutjnl-2020-323611

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    2021-11-27 1482a9ccm99(暂无昵称)

    看不明白这些数据

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1074500, encodeId=361010e450029, content=看不明白这些数据, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=976d5273688, createdName=1482a9ccm99(暂无昵称), createdTime=Sat Nov 27 14:17:12 CST 2021, time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=961916, encodeId=360596191687, content=<a href='/topic/show?id=49e383289e' target=_blank style='color:#2F92EE;'>#Gut#</a>点击进入话题查看更多相关文章 或评论时插入话题加入讨论, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8328, encryptionId=49e383289e, topicName=Gut)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Fri Apr 30 17:30:13 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=955467, encodeId=d0d495546ea9, content=期待, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44b35478479, createdName=肝胆想招, createdTime=Fri Apr 09 14:14:20 CST 2021, time=2021-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959543, encodeId=569b959543d8, content=怎么及时筛选胰腺癌, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 22 20:11:12 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=955479, encodeId=9ff89554e993, content=尽管同时使用了两种成像方式,但EUS的表现优于MRI/MRCP,因此及时识别可切除的病变被证明具有挑战性。总体而言,通过影像学手段监测产生的效果欠佳,因此,我们还是需要更敏感的诊断标志物,包括生物标志物。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Apr 09 15:08:22 CST 2021, time=2021-04-09, status=1, ipAttribution=)]
    2021-04-30 MedSciZeng

    #Gut#点击进入话题查看更多相关文章 或评论时插入话题加入讨论

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    2021-04-09 肝胆想招

    期待

    0

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    2021-04-22 科研科研科研

    怎么及时筛选胰腺癌

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1074500, encodeId=361010e450029, content=看不明白这些数据, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=976d5273688, createdName=1482a9ccm99(暂无昵称), createdTime=Sat Nov 27 14:17:12 CST 2021, time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=961916, encodeId=360596191687, content=<a href='/topic/show?id=49e383289e' target=_blank style='color:#2F92EE;'>#Gut#</a>点击进入话题查看更多相关文章 或评论时插入话题加入讨论, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8328, encryptionId=49e383289e, topicName=Gut)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Fri Apr 30 17:30:13 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=955467, encodeId=d0d495546ea9, content=期待, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44b35478479, createdName=肝胆想招, createdTime=Fri Apr 09 14:14:20 CST 2021, time=2021-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959543, encodeId=569b959543d8, content=怎么及时筛选胰腺癌, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 22 20:11:12 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=955479, encodeId=9ff89554e993, content=尽管同时使用了两种成像方式,但EUS的表现优于MRI/MRCP,因此及时识别可切除的病变被证明具有挑战性。总体而言,通过影像学手段监测产生的效果欠佳,因此,我们还是需要更敏感的诊断标志物,包括生物标志物。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Fri Apr 09 15:08:22 CST 2021, time=2021-04-09, status=1, ipAttribution=)]
    2021-04-09 随梦飞扬

    尽管同时使用了两种成像方式,但EUS的表现优于MRI/MRCP,因此及时识别可切除的病变被证明具有挑战性。总体而言,通过影像学手段监测产生的效果欠佳,因此,我们还是需要更敏感的诊断标志物,包括生物标志物。

    0

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