[Diagnosis of early pancreatic cancer and precursor lesions]

Pancreatic cancer is a malignancy, which usually carries a poor prognosis; the 5-year survival is less than 6%. Therefore, its early detection in a stage when curable resection can be performed is essential to give the patients the best possible chance for a long-term survival. Despite the use of the most up-to-date diagnostic procedures, an early diagnosis of pancreatic carcinoma is rather unsuccessful. Furthermore, long-term survival rates for pancreatic cancer patients are still unsatisfactory, even when diagnosed early. Nevertheless, alterations occur in biomolecules as early as during the onset of oncogenesis, which can be detected by structure-sensitive spectroscopic methods. These methods provide a potential for detecting a sufficiently specific biomarker of early pancreatic carcinoma. A pilot study using molecular spectroscopy was conducted at the 1st Department of Internal Medicine, 1st Faculty of Medicine, Charles University and Military University Hospital in Prague, Czech Republic, in cooperation with the Department of Analytical Chemistry, University of Chemistry and Technology in Prague, Czech Republic. In the study, we compared the spectral response of blood plasma of patients with pancreatic carcinoma and healthy controls. Molecular spectroscopy provided evidence of significant differences between the two groups as illustrated by the study results. This approach thus might be suitable for detecting a specific biomarker of early pancreatic carcinoma. The findings have forced us to rethink the practical benefits of all potential biomarkers. In the future, we might face a situation where although any given marker is positive in a patient, no convincing morphological correlation can be found using available imaging methods. An important question is thus raised - whether or not to indicate surgical resection only on the basis of the biomarker positivity, and what type of resection to opt for.Key words: pancreatic cancer - early detection - spectroscopy - pancreatectomy.