Advances in pancreatic cancer research: Moving towards early detection

• Published in: World journal of gastroenterology : WJG Vol. 20; no. 32; pp. 11241 - 11248
• Main Authors: He, Xiang-Yi, Yuan, Yao-Zong
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 28.08.2014
• Subjects: adenocarcinoma; Biomarkers, Tumor - blood; Biomarkers, Tumor - genetics; Carcinoma, Pancreatic Ductal - blood; Carcinoma, Pancreatic Ductal - diagnosis; Carcinoma, Pancreatic Ductal - genetics; Carcinoma, Pancreatic Ductal - mortality; Carcinoma, Pancreatic Ductal - pathology; Carcinoma, Pancreatic Ductal - surgery; detection; Diabetes Mellitus - epidemiology; ductal; early; Early Detection of Cancer - methods; Genetic Testing; Humans; Neoplasm Staging; Pancreatic; Pancreatic Neoplasms - blood; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - genetics; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Predictive Value of Tests; Risk Factors; Topic Highlight; Diabetes mellitus; Pancreatic cancer; Pancreatic ductal adenocarcinoma; Early detection
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v20.i32.11241

Pancreatic ductal adenocarcinoma(PDAC) is one of the most lethal forms of cancer. Substantial progress has been made in the understanding of the biology of pancreatic cancer, and advances in patient management have been significant. However, most patients(nearly80%) who present with locally advanced or metastatic disease have an extremely poor prognosis. Survival is better for those with malignant disease localized to the pancreas, because surgical resection at present offers the only chance of cure. Therefore, the early detection of pancreatic cancer may benefit patients with PDAC.However, its low rate of incidence and the limitations of current screening strategies make early detection difficult. Recent advances in the understanding of the pathogenesis of PDAC suggest that it is possible to detect PDAC in early stages and even identify precursor lesions. The presence of new-onset diabetes mellitus in the early phase of pancreatic cancer may provide cluesfor its early diagnosis. Advances in the identification of novel circulating biomarkers including serological signatures, autoantibodies, epigenetic markers, circulating tumor cells and microRNAs suggest that they can be used as potential tools for the screening of precursors and early stage PDAC in the future. However, proper screening strategies based on effective screening methodologies need to be tested for clinical application.