Role of endoscopic ultrasound in the screening and follow-up of high-risk individuals for familial pancreatic cancer

作     者：Diane Lorenzo Vinciane Rebours Frédérique Maire Maxime Palazzo Jean-Michel Gonzalez Marie-Pierre Vullierme Alain Aubert Pascal Hammel Philippe Lévy Louis de Mestier 

作者机构：Pancreatology DepartmentBeaujon HospitalAssistance Publique-Hopitaux de ParisClichyand Paris Diderot UniversityParis 75013France INSERMUMR1149Paris 92110France Departement of GastroenterologyAix Marseille university-APHM-Hopital NordMarseille 13000France Radiology DepartmentBeaujon HospitalAssistance Publique-Hopitaux de ParisClichyand Paris Diderot UniversityParis 92110France Oncology DepartmentBeaujon HospitalAssistance Publique-Hopitaux de ParisClichyand Paris Diderot UniversityParis 92110France 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2019年第25卷第34期

页      面：5082-5096页

核心收录：

学科分类：10[医学] 

主　　题：Endoscopic ultrasound Familial pancreatic cancer Fine-needle aspiration Intraductal papillary mucinous neoplasm Pancreatic cancer Pancreatic intraepithelial neoplasia Pancreatic cancer screening guidelines 

摘      要：Managing familial pancreatic cancer(FPC)is challenging for gastroenterologists,surgeons and ***-risk individuals(HRI)for pancreatic cancer(PC)(FPC or with germline mutations)are a heterogeneous group of subjects with a theoretical lifetime cumulative risk of PC over 5%.Screening is mainly based on annual magnetic resonance imaging(MRI)and endoscopic ultrasound(EUS).The goal of screening is to identify early-stage operable cancers or high-risk precancerous lesions(pancreatic intraepithelial neoplasia or intraductal papillary mucinous neoplasms with high-grade dysplasia).In the literature,target lesions are identified in 2%-5%of HRI who undergo *** appears to provide better identification of small solid lesions(0%-46%of HRI)and chronicpancreatitis-like parenchymal changes(14%-77%of HRI),while MRI is probably the best modality to identify small cystic lesions(13%-49%of HRI).There are no specific studies in HRI on the use of contrast-enhanced harmonic *** can also be used to obtain tissue ***,there is still limited evidence on the accuracy of imaging procedures used for screening or agreement on which patients to *** cost-effectiveness of screening is also *** new EUS-related techniques,such as searching for DNA abnormalities or protein markers in pancreatic fluid,appear to be promising.