胰腺癌
Terumi Kamisawa1, Laura D Wood2, Takao Itoi3
1Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
Lancet (London, England)
|February 3, 2016
概括
胰腺癌是一种致命的疾病, 早期检测和治疗选择如手术和化疗对于改善这一具有挑战性的癌症的结果至关重要.
科学领域:
- 癌症学
- 胃肠病学
背景情况:
- 胰腺癌的死亡率很高,大多数患者在晚期无症状.
- 对于高危人群,包括家族病史或慢性胰腺炎患者,没有标准的查.
- 胰腺瘤通常源于称为胰腺内皮质瘤的微观前体病变.
研究的目的:
- 审查目前对胰腺癌的理解,包括其发病,诊断和治疗.
- 突出关键的遗传驱动因素和诊断方式.
- 概述可切除和不可切除的胰腺癌的治疗策略.
主要方法:
- 关于胰腺癌发病,遗传学和临床管理的文献综述.
- 分析诊断技术,如内镜超声波和精细针吸收.
- 目前治疗指南的摘要,包括手术切除,辅助化疗和全身疗法.
主要成果:
- KRAS,CDKN2A,TP53和SMAD4是主要的驱动基因,KRAS突变和CDKN2A改变是早期事件.
- 透视超声波 (EUS) 和EUS引导的细针吸收 (FNA) 显示出高的诊断准确性.
- 手术切除提供了唯一的潜在治疗方法,建议在手术后进行辅助化疗 (gemcitabine或S-1).
结论:
- 由于晚期无症状呈现,胰腺癌需要早期检测.
- 多种治疗方法,包括手术和化疗 (FOLFIRINOX或gemcitabine/ nab- paclitaxel) 是必要的.
- 对查和早期干预的进一步研究对于改善患者存活率至关重要.
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