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Pancreatic ductal adenocarcinoma screening:New perspectives 被引量:8
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作者 Raffaele Pezzilli Dario Fabbri Andrea Imbrogno 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第36期4973-4977,共5页
Pancreatic ductal adenocarcinoma accounts for more than 90% of all pancreatic cancers and its incidence has increased significantly worldwide.Patients with pancreatic ductal adenocarcinoma have a poor outcome and more... Pancreatic ductal adenocarcinoma accounts for more than 90% of all pancreatic cancers and its incidence has increased significantly worldwide.Patients with pancreatic ductal adenocarcinoma have a poor outcome and more than 95% of the people affected die from the disease within 12 mo after diagnosis.Surgery is the first-line treatment in the case of resectable neoplasm,but only 20% of patients are candidates for this approach.One of the reasons there are few candidates for surgery is that,during the early phases of the disease,the symptoms are poor or non-specific.Early diagnosis is of crucial importance to improve patient outcome;therefore,we are looking for a good screening test.The screening test must identify the disease in an early stage in order to be effective;having said this,a need exists to introduce the concept of "early" ductal adenocarcinoma.It has been reported that at least five additional years after the occurrence of the initiating mutation are required for the acquisition of metastatic ability of pancreatic adenocarcinoma and patients die an average of two years thereafter.We have reviewed the most recent literature in order to evaluate the present and future perspectives of screening programs of this deadly disease. 展开更多
关键词 Pancreatic neoplasms Study population PREVENTION THERAPEUTICS
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Progress in pancreatic cancer therapeutics: The potential to exploit molecular targets
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作者 Kiruthikah Thillai Debashis Sarker Paul Ross 《World Journal of Pharmacology》 2015年第2期180-192,共13页
Pancreatic ductal adenocarcinoma is an aggressive and devastating disease associated with poor survival outcomes. Even though signifcant advances have been made towards understanding the intricate pathology of this ca... Pancreatic ductal adenocarcinoma is an aggressive and devastating disease associated with poor survival outcomes. Even though signifcant advances have been made towards understanding the intricate pathology of this cancer, several important aspects remain unknown. Recently, key genetic mutations within the tumour have been identified, but the exact role they play in tumourigenesis has yet to be determined.For many years, the micro-tumour environment and stroma was thought to aid proliferation but there is now emerging research that suggests the contrary. Several novel targeted agents in pre-clinical and early clinical studies have been promising but it remains to be seen whether they will have a signifcant impact on patient outcomes. In this review we discuss the unique nature of pancreatic cancer biology, current treatment options and summarise the latest results from pre-clinical and clinical research. We also discuss the future strategies that are needed to improve outcomes for this disease. 展开更多
关键词 Pancreatic cancer ADENOCARCINOMA Targeted therapy GENOMICS Stroma KRAS Chemotherapy
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胰十二指肠下静脉的影像学解剖特征及临床意义 被引量:1
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作者 徐强 吴文铭 +5 位作者 廖泉 戴梦华 张太平 郭俊超 丛林 赵玉沛 《中华消化外科杂志》 CAS CSCD 北大核心 2019年第6期575-580,共6页
目的探讨胰十二指肠下静脉(IPDV)的影像学解剖特征及临床意义。方法采用回顾性描述性研究方法。收集2018年1月至6月北京协和医院收治的42例胰头导管腺癌患者的临床病理资料;男24例,女18例;平均年龄为61岁,年龄范围为41~78岁。患者术前行... 目的探讨胰十二指肠下静脉(IPDV)的影像学解剖特征及临床意义。方法采用回顾性描述性研究方法。收集2018年1月至6月北京协和医院收治的42例胰头导管腺癌患者的临床病理资料;男24例,女18例;平均年龄为61岁,年龄范围为41~78岁。患者术前行1 mm层距的CT增强扫描检查,根据术前评估行相应手术治疗。观察指标:(1)术前CT检查结果。(2)手术情况。采用Shapiro-Wilk检验计量资料的正态性假设,偏态分布的计量资料以M(QR)或M(范围)表示,组间比较采用Mann-Whitney U检验。计数资料以绝对数或百分比表示,组间比较采用χ^2检验。结果(1)术前CT检查结果:42例患者术前均行层间距为1 mm的CT增强扫描检查。CT检查结果显示:①42例患者均存在第一空肠静脉干,其中34例第一空肠静脉干走行于肠系膜上动脉(SMA)背侧,8例第一空肠静脉干走行于SMA腹侧。②42例患者中,2例未显示IPDV;40例存在IPDV,其中23例存在1支IPDV,13例存在2支IPDV,3例存在3支IPDV,1例存在4支IPDV。42例患者共检出62支IPDV,人均IPDV为1支(0~4支),其中43支汇入第一空肠静脉干或第二空肠静脉干,19支汇入肠系膜上静脉(SMV)。③42例患者中,32例为Ⅰ型IPDV(1支IPDV汇入SMA背侧空肠静脉干20例、2支IPDV汇入SMA背侧空肠静脉干7例、3支IPDV汇入SMA背侧空肠静脉干2例、1支IPDV汇入SMA腹侧空肠静脉干3例),10例为非Ⅰ型IPDV;18例为Ⅱ型IPDV(1支IPDV汇入SMV 17例、2支IPDV汇入SMV 1例),24例为非Ⅱ型IPDV。患者可同时合并Ⅰ型和Ⅱ型IPDV。(2)手术情况:42例患者均施行胰十二指肠切除术,其中腹腔镜手术14例,开放手术28例;术中SMV和(或)门静脉切除重建5例;术中输血18例;术后病理学检查结果均为胰头导管腺癌,R0切除30例、R1切除12例。42例患者中,32例Ⅰ型IPDV患者的术中出血量为650 mL(853 mL),术中输血15例,手术切缘情况(R0和R1切除)分别为20例和12例,SMV和(或)门静脉切除重建为4例;10例非Ⅰ型IPDV患者的上述指标分别为475 mL(480 mL),3例,10例和0例,1例。Ⅰ型IPDV和非Ⅰ型IPDV患者术中出血量、手术切缘情况比较,差异均有统计学意义(Z=94.000,χ^2=5.250,P<0.05);Ⅰ型IPDV和非Ⅰ型IPDV患者术中输血例数、SMV和(或)门静脉切除重建比较,差异均无统计学意义(χ^2=0.045,0.886,P>0.05)。结论薄层增强CT检查可分辨IPDV,IPDV有汇入SMV或空肠静脉干两种类型。胰十二指肠切除术中应注意处理汇入空肠静脉干的IPDV,汇入空肠静脉干的IPDV患者术中出血量更多,R0切除率更低。 展开更多
关键词 胰腺导管腺肿瘤 胰腺导管 胰十二指肠下静脉 胰十二指肠切除术 影像学特征 体层摄影术 X线计算机
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