胰腺炎
医学
胰腺癌
内镜超声
遗传性胰腺炎
CDKN2A
胃肠病学
癌症
内科学
自身免疫性胰腺炎
病理
放射科
胰蛋白酶原
生物化学
胰蛋白酶
化学
酶
作者
Guillaume Le Cosquer,Charlotte Maulat,Barbara Bournet,Pierre Cordelier,Étienne Buscail,Louis Buscail
出处
期刊:Cancers
[MDPI AG]
日期:2023-01-26
卷期号:15 (3): 761-761
被引量:23
标识
DOI:10.3390/cancers15030761
摘要
Chronic pancreatitis is one of the main risk factors for pancreatic cancer, but it is a rare event. Inflammation and oncogenes work hand in hand as key promoters of this disease. Tobacco is another co-factor. During alcoholic chronic pancreatitis, the cumulative risk of cancer is estimated at 4% after 15 to 20 years. This cumulative risk is higher in hereditary pancreatitis: 19 and 12% in the case of PRSS1 and SPINK1 mutations, respectively, at an age of 60 years. The diagnosis is difficult due to: (i) clinical symptoms of cancer shared with those of chronic pancreatitis; (ii) the parenchymal and ductal remodeling of chronic pancreatitis rendering imaging analysis difficult; and (iii) differential diagnoses, such as pseudo-tumorous chronic pancreatitis and paraduodenal pancreatitis. Nevertheless, the occurrence of cancer during chronic pancreatitis must be suspected in the case of back pain, weight loss, unbalanced diabetes, and jaundice, despite alcohol withdrawal. Imaging must be systematically reviewed. Endoscopic ultrasound-guided fine-needle biopsy can contribute by targeting suspicious tissue areas with the help of molecular biology (search for KRAS, TP53, CDKN2A, DPC4 mutations). Short-term follow-up of patients is necessary at the clinical and paraclinical levels to try to diagnose cancer at a surgically curable stage. Pancreatic surgery is sometimes necessary if there is any doubt.
科研通智能强力驱动
Strongly Powered by AbleSci AI