Rak trzustki
Diagnostyka i diagnoza
Rak trzustki charakteryzuje się wysoką złośliwością i niskim 5-letnim wskaźnikiem przeżycia około 6%, co wynika z trudności w wczesnej diagnostyce spowodowanej głębokim położeniem narządu i bezobjawowym przebiegiem w początkowych stadiach. Diagnostyka opiera się na szczegółowym wywiadzie, badaniu fizykalnym oraz badaniach laboratoryjnych, w tym ocenie funkcji wątroby i markerów nowotworowych (CA 19-9 o czułości 50-75% i swoistości 83%, CEA o niskiej wartości diagnostycznej). Kluczową rolę odgrywają badania obrazowe: tomografia komputerowa (TK) z protokołem trzustkowym (czułość 90-95%), rezonans magnetyczny (MRI), cholangiopankreatografia rezonansu magnetycznego (MRCP, czułość 84%, swoistość 97%), endoskopowa ultrasonografia (EUS, wykrywalność 99-100%) oraz endoskopowa cholangiopankreatografia wsteczna (ERCP, nieprawidłowości u 90-95% pacjentów). Definitywne rozpoznanie stawia się na podstawie biopsji, najczęściej cienkoigłowej pod kontrolą EUS (EUS-FNA) o czułości 90,8% i swoistości 96,5%.
Diagnostyka raka trzustki
Rak trzustki jest jednym z najbardziej złośliwych nowotworów, charakteryzującym się wysoką śmiertelnością i trudnościami w diagnostyce na wczesnym etapie rozwoju. Jest to czwarta najczęstsza przyczyna zgonów z powodu nowotworów, z 5-letnim wskaźnikiem przeżycia wynoszącym zaledwie około 6% przy uwzględnieniu wszystkich stadiów choroby1. Wczesne wykrycie raka trzustki jest kluczowe dla poprawy rokowania, jednak ze względu na położenie trzustki głęboko w jamie brzusznej oraz często bezobjawowy przebieg we wczesnych stadiach, diagnostyka stanowi duże wyzwanie23.
Wyzwania w diagnostyce
Trzustka jest położona w przestrzeni zaotrzewnowej, gdzie wczesny wzrost nowotworu przebiega bezobjawowo, dlatego objawy są zwykle oznaką zaawansowanej choroby1. Około 80-85% przypadków raka trzustki jest wykrywanych w stadium, gdy nowotwór nie kwalifikuje się do resekcji chirurgicznej ze względu na rozległe rozprzestrzenienie2. Objawy kliniczne zależą od stadium choroby i lokalizacji guza pierwotnego, a mogą obejmować ból brzucha, żółtaczkę, utratę masy ciała, nudności i inne niespecyficzne dolegliwości13.
Warto podkreślić, że nie istnieje standardowy test przesiewowy zalecany dla ogólnej populacji w celu wczesnego wykrywania raka trzustki12. Obecnie metody wczesnego wykrywania są zalecane głównie dla osób z grupy wysokiego ryzyka, takich jak osoby z silnym wywiadem rodzinnym, nosiciele mutacji genetycznych czy pacjenci z przewlekłym zapaleniem trzustki1.
Badania diagnostyczne
Wywiad i badanie fizykalne
Proces diagnostyczny raka trzustki zazwyczaj rozpoczyna się od wizyty u lekarza rodzinnego, który przeprowadza szczegółowy wywiad dotyczący objawów, czynników ryzyka oraz historii rodzinnej chorób nowotworowych1. Podczas badania fizykalnego lekarz ocenia jamę brzuszną pod kątem zmian w obszarach w pobliżu trzustki, wątroby, pęcherzyka żółciowego i śledziony. Sprawdza również, czy występuje nieprawidłowe gromadzenie się płynu w jamie brzusznej, a także ocenia skórę i oczy pod kątem objawów żółtaczki2.
Na podstawie tych informacji lekarz może skierować pacjenta do specjalisty lub zlecić dodatkowe badania w celu potwierdzenia lub wykluczenia raka trzustki3.
Badania laboratoryjne
Badania krwi mogą dostarczyć istotnych informacji, ale same w sobie nie są wystarczające do postawienia diagnozy raka trzustki1. Najczęściej wykonywane badania laboratoryjne obejmują:
- Testy funkcji wątroby – oceniają poziom bilirubiny i enzymów wątrobowych, które mogą być podwyższone w przypadku blokady dróg żółciowych przez guz trzustki12.
- Markery nowotworowe – CA 19-9 jest najczęściej wykorzystywanym markerem w diagnostyce raka trzustki, jednak jego czułość (50-75%) i swoistość (83%) są niewystarczające do skutecznego badania przesiewowego u osób bezobjawowych1. Podwyższony poziom CA 19-9 może wskazywać na obecność raka trzustki, ale nie jest specyficzny wyłącznie dla tego nowotworu i może być również podwyższony w innych chorobach, takich jak rak jelita grubego, rak dróg żółciowych, rak wątroby, rak żołądka, a nawet w schorzeniach nienowotworowych, jak żółtaczka mechaniczna, marskość wątroby czy zapalenie dróg żółciowych2.
- Antygen rakowo-zarodkowy (CEA) – również ma niską wartość diagnostyczną3.
Warto podkreślić, że markery nowotworowe są bardziej przydatne do monitorowania odpowiedzi na leczenie i wykrywania nawrotów niż do pierwotnej diagnostyki12.
Badania obrazowe
Badania obrazowe odgrywają kluczową rolę w diagnostyce raka trzustki. Są one jedynym sposobem na wizualizację guza trzustki, dlatego mają zasadnicze znaczenie w rozpoznawaniu i monitorowaniu choroby1. Do najważniejszych technik obrazowania należą:
- Tomografia komputerowa (TK) – jest najczęściej stosowanym i najbardziej czułym badaniem w diagnostyce raka trzustki1. Wielofazowa TK z protokołem trzustkowym (z podaniem kontrastu dożylnie i doustnie) jest badaniem pierwszego wyboru2. Pozwala na dokładną ocenę trzustki i okolicznych tkanek, wykrycie guza, określenie jego wielkości oraz ocenę, czy nowotwór może być całkowicie usunięty chirurgicznie3. Przy użyciu najnowszego sprzętu i doświadczonych operatorów, badanie to może wykryć 90-95% raków trzustki4.
- Rezonans magnetyczny (MRI) – jest często stosowany jako badanie drugiej linii w przypadku niejednoznacznych wyników TK lub gdy badanie TK z kontrastem jest przeciwwskazane1. MRI wykorzystuje pola magnetyczne i fale radiowe zamiast promieniowania rentgenowskiego do tworzenia szczegółowych obrazów trzustki i okolicznych narządów2.
- Cholangiopankreatografia rezonansu magnetycznego (MRCP) – jest specjalistycznym badaniem MRI, które dostarcza szczegółowych obrazów dróg żółciowych i trzustkowych1. Czułość MRCP w diagnostyce raka trzustki szacuje się na 84%, przy swoistości 97%2.
- Endoskopowa ultrasonografia (EUS) – jest nowszą procedurą, która może diagnozować raka trzustki z większą dokładnością niż ultrasonografia przezbrzuszna1. Podczas badania EUS cienka sonda endoskopu jest wprowadzana przez jamę ustną, przełyk i żołądek do pierwszej części jelita cienkiego. Ultradźwiękowa sonda na końcu endoskopu wysyła fale dźwiękowe, które odbijają się od tkanek trzustki, tworząc szczegółowy obraz2. EUS ma wykrywalność 99-100% dla wszystkich raków trzustki, nawet tych mniejszych niż 3 cm3.
- Endoskopowa cholangiopankreatografia wsteczna (ERCP) – jest wysoce czułą metodą wykrywania nieprawidłowości w drogach trzustkowych i/lub żółciowych w raku trzustki1. U 90-95% pacjentów z gruczolakorakiem trzustki wyniki ERCP są nieprawidłowe2. Podczas ERCP lekarz wprowadza endoskop przez jamę ustną i żołądek do pierwszej części jelita cienkiego. Następnie wprowadza mniejszą rurkę przez endoskop do dróg żółciowych i trzustkowych. Po wstrzyknięciu barwnika przez mniejszą rurkę do przewodów, lekarz wykonuje zdjęcia rentgenowskie, które mogą pokazać, czy przewody są zwężone lub zablokowane przez guz3.
- Pozytonowa tomografia emisyjna (PET) lub PET-CT – jest wykorzystywana do wykrywania guzów trzustki i oceny, czy nowotwór rozprzestrzenił się na inne narządy i tkanki1. W badaniu PET do krwi wstrzykiwana jest niewielka ilość radioaktywnego cukru, który gromadzi się głównie w komórkach nowotworowych2.
Biopsja
Biopsja jest jedynym definitywnym sposobem diagnozowania raka trzustki1. Polega na pobraniu małej próbki tkanki do badania pod mikroskopem. Patolog analizuje próbkę, aby stwierdzić, czy zawiera komórki nowotworowe, a jeśli tak, to jakiego typu2.
Istnieje kilka metod pobierania próbek tkanki trzustki:
- Biopsja cienkoigłowa pod kontrolą EUS (EUS-FNA) – okazała się najbardziej skuteczną metodą postawienia definitywnej cytologicznej diagnozy raka trzustki1. Metaanaliza obejmująca 20 badań i 2761 pacjentów wykazała, że EUS-FNA ma czułość 90,8% i swoistość 96,5% w diagnostyce litych zmian trzustki2.
- Biopsja przezskórna pod kontrolą TK lub USG – cienka igła jest wprowadzana przez skórę do guza trzustki w celu pobrania próbki1.
- Laparoskopia diagnostyczna – jest małym zabiegiem chirurgicznym, podczas którego w jamie brzusznej wykonuje się małe nacięcie, przez które wprowadza się laparoskop w celu przeprowadzenia badania wewnętrznego1.
Warto zaznaczyć, że rozpoznanie histologiczne nie jest konieczne przed operacją w przypadku guzów potencjalnie resekcyjnych. Jednak jest wymagane przed rozpoczęciem leczenia neoadjuwantowego oraz u pacjentów z miejscowo zaawansowanym lub przerzutowym rakiem trzustki1.
Ocena zaawansowania choroby
System TNM
Po potwierdzeniu diagnozy raka trzustki, lekarze określają stopień zaawansowania nowotworu, co jest kluczowym czynnikiem przy podejmowaniu decyzji dotyczących leczenia1. System TNM (Tumor, Nodes, Metastasis) jest powszechnie stosowany do określania stopnia zaawansowania raka trzustki:
- T (Tumor) – określa wielkość guza pierwotnego i stopień nacieku okolicznych tkanek
- N (Nodes) – określa, czy nowotwór rozprzestrzenił się do okolicznych węzłów chłonnych
- M (Metastasis) – określa, czy występują przerzuty odległe1
Na podstawie tych parametrów, rak trzustki klasyfikuje się w skali od 0 do IV, gdzie wyższe stopnie oznaczają bardziej zaawansowaną chorobę2.
Ocena resekcyjności
Jednym z najważniejszych aspektów oceny stopnia zaawansowania raka trzustki jest określenie, czy nowotwór może być usunięty chirurgicznie (resekcyjność). Generalnie guzy trzustki klasyfikuje się jako:
- Resekcyjne – guzy, które można całkowicie usunąć chirurgicznie
- Granicznie resekcyjne – guzy z częściowym przyleganiem lub otoczeniem żył wrotnych lub żył krezkowych górnych, gdzie operacja jest podejmowana tylko wtedy, gdy możliwa jest całkowita resekcja1
- Miejscowo zaawansowane – nowotwór, który nie może być usunięty chirurgicznie ze względu na naciekanie ważnych struktur naczyniowych lub nerwowych
- Przerzutowe – nowotwór, który rozprzestrzenił się do odległych narządów, takich jak wątroba czy płuca2
Kliniczny system oceny resekcyjności (system Evansa i wsp.) opiera się na radiograficznych dowodach przylegania lub otaczania struktur naczyniowych oraz stopniu zwężenia żyły krezkowej górnej i/lub żyły wrotnej1.
Nowe kierunki w diagnostyce
Testy molekularne
Postęp w dziedzinie diagnostyki molekularnej otwiera nowe możliwości w diagnostyce raka trzustki. Testy diagnostyki molekularnej mogą wykrywać specyficzne mutacje genetyczne i biomarkery związane z rakiem trzustki, umożliwiając wcześniejszą diagnozę i bardziej precyzyjne leczenie1.
W Memorial Sloan Kettering Cancer Center opracowano test genetyczny MSK-IMPACT, który jest sekwencjonowaniem DNA nowej generacji. Test ten poszukuje mutacji w komórkach nowotworowych i przy użyciu niewielkiej próbki tkanki może wykryć zmiany genetyczne w 505 genach1. Badania nad profilowaniem molekularnym mogą pomóc w identyfikacji potencjalnych celów dla terapii celowanej2.
Biopsja płynna
Biopsja płynna to rodzaj testu, który wykorzystuje krew lub inne płyny ustrojowe do wykrywania lub monitorowania raka. Naukowcy opracowali test krwi, który może dokładnie wykrywać wczesne stadium raka trzustki1.
Test opracowany przez dr Ajaya Goela i jego współpracowników z City of Hope Duarte Cancer Center w Kalifornii analizuje małe fragmenty RNA uwalniane przez guzy. Badanie, które objęło prawie 1000 osób z kilku krajów, wykazało, że test dokładnie wykrywał wczesne i późne stadium raka trzustki w dużej i zróżnicowanej grupie ludzi2.
Co więcej, gdy badacze połączyli swój test krwi z testem wykrywającym białko CA19-9, ta kombinacja dokładnie zidentyfikowała 97% osób z wczesnym stadium raka trzustki3.
Sztuczna inteligencja
Sztuczna inteligencja (AI) jest stosowana w dziedzinie inteligentnej diagnostyki obrazowej chorób trzustki i osiąga znaczące postępy1. AI próbuje wykorzystać modele komputerowe do diagnostyki cytologicznej trzustki, szczególnie w próbkach z biopsji cienkoigłowej pod kontrolą endoskopowej ultrasonografii (EUS-FNA)2.
AI może również być stosowana do analizy markerów biologicznych, co może zwiększyć czułość i swoistość testów diagnostycznych3.
Badania przesiewowe
Grupy wysokiego ryzyka
Bezpośrednie badania przesiewowe pacjentów z rakiem trzustki z populacji ogólnej są trudne i nieopłacalne ze względu na brak testów o wysokiej swoistości i niską częstość występowania raka trzustki1. Jednak zastosowanie strategii badań przesiewowych w przypadku sporadycznego raka trzustki u osób z jednym lub więcej czynnikami ryzyka mogłoby zwiększyć skuteczność potencjalnego testu przesiewowego2.
Obecnie badania przesiewowe w kierunku raka trzustki są zalecane głównie dla osób z grupy wysokiego ryzyka, takich jak:
- Osoby z silnym wywiadem rodzinnym raka trzustki
- Nosiciele mutacji genetycznych (BRCA1, BRCA2, STK11, CDK2NA, PRSS1 i zespół Lyncha)
- Osoby z przewlekłym zapaleniem trzustki
- Osoby z nowo rozpoznaną cukrzycą, szczególnie powyżej 50. roku życia12
National Comprehensive Cancer Network (NCCN) zaleca stosowanie endoskopowej ultrasonografii (EUS) u osób z grupy wysokiego ryzyka genetycznego/rodzinnego1.
Metody badania przesiewowego
Dla osób z grupy wysokiego ryzyka raka trzustki, najczęściej stosowane metody badań przesiewowych obejmują:
- Endoskopową ultrasonografię (EUS) – może wykrywać zmiany przedrakowe i wczesne raki trzustki1
- MRI/MRCP – dostarcza szczegółowych obrazów trzustki i dróg trzustkowych bez narażania na promieniowanie2
- Testy krwi w kierunku biomarkerów – chociaż obecnie nie ma wystarczająco czułych i swoistych biomarkerów do badań przesiewowych w populacji ogólnej1
Lekarze byli w stanie wykryć wczesne, poddające się leczeniu raki trzustki u niektórych członków rodzin wysokiego ryzyka za pomocą tych testów1.
Podsumowanie i wyzwania
Diagnostyka raka trzustki pozostaje wyzwaniem ze względu na brak wczesnych objawów, trudności w obrazowaniu trzustki oraz ograniczoną skuteczność dostępnych markerów. Tomografia komputerowa z protokołem trzustkowym jest obecnie badaniem pierwszego wyboru, a endoskopowa ultrasonografia z biopsją cienkoigłową dostarcza najdokładniejszego rozpoznania cytologicznego12.
Wykrycie raka trzustki we wczesnym stadium jest kluczowe dla skutecznego leczenia. Wskaźniki 5-letniego przeżycia wynoszą około 44% dla wczesnego stadium, w porównaniu do zaledwie 3% dla stadium zaawansowanego1.
Trwają intensywne badania nad nowymi metodami wczesnego wykrywania, w tym nad bardziej czułymi biomarkerami, technikami obrazowania, biopsją płynną i zastosowaniem sztucznej inteligencji1. Te innowacyjne podejścia mogą w przyszłości poprawić wczesną diagnostykę raka trzustki i, co za tym idzie, rokowanie dla pacjentów.
Należy podkreślić, że rozpoznanie raka trzustki powinno być dokonywane przez interdyscyplinarny zespół specjalistów, a decyzje dotyczące leczenia powinny uwzględniać indywidualne cechy pacjenta, stadium choroby oraz możliwości terapeutyczne12.
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Materiały źródłowe
- #1 Diagnosis and management of pancreatic cancerhttps://pmc.ncbi.nlm.nih.gov/articles/PMC3787168/
About 1 in 79 Canadians will have pancreatic cancer in their lifetime, making it the 12th most common malignant disease and the 4th leading cause of death from cancer. A family physician can expect to encounter 1 to 2 patients with pancreatic cancer each year, with increases in case volumes anticipated as the Canadian population grows and ages. When considering all stages, the overall 5-year survival for pancreatic cancer is about 6%, making it one of the most fatal diseases. […] In the clinical setting, and for the purpose of this article, we use the term pancreatic cancer to refer to the ductal adenocarcinoma subtype, which accounts for 90% of cases. The aim of this article is to explore our current evidence-based understanding of pancreatic cancer, focusing on diagnostic and treatment strategies relevant to the general clinician.
- #1 Diagnosis and management of pancreatic cancerhttps://pmc.ncbi.nlm.nih.gov/articles/PMC3787168/
A latency period of about 10 years between the start of pancreatic carcinogenesis and symptomatic disease has been shown. Thus, there is a theoretical benefit to screening; however, there is no consensus as to its optimal modality, interval or duration. […] The pancreas is located in the retroperitoneum, where initial growth of the cancer is silent; therefore, symptoms are usually a sign of advanced disease. Clinical presentation depends on the stage of disease and the location of the primary tumour. […] Tumour markers have minimal diagnostic utility in pancreatic cancer. Biomarkers that have been evaluated include CA 19-9, which has poor positive predictive value in both asymptomatic and symptomatic patients, and carcinoembryonic antigen, which also has a low diagnostic yield. […] The putative diagnosis and stage of pancreatic cancer is usually made with triphasic contrast-enhanced abdominal CT, which provides orientation of the tumour with surrounding vessels and organs.
- #1 Pancreatic Cancer Early Detection â Pancreatic Cancer Action Networkhttps://pancan.org/facing-pancreatic-cancer/diagnosis/early-detection/
Today, pancreatic cancer early detection or screening methods focus on those at high risk. These options include: Surveillance programs, Regular imaging scans, Blood-based tests. […] No universal screening tests for pancreatic cancer in the general population exist yet. […] Methods to detect cancer in people at increased risk are especially important. […] In a surveillance, early detection or screening program, doctors actively check people who are at risk of getting pancreatic cancer. The goal is to find pancreatic cancer and pre-cancerous lesions earlier in those who develop the disease. […] Current pancreatic cancer surveillance programs study people at high risk due to family history, an inherited genetic mutation, new onset diabetes or chronic pancreatitis. […] A biomarker is a substance found in the body that can be measured. The amount of a biomarker may differ between a healthy person and someone with a disease. This means biomarkers may aid in detecting that disease.
- #1 microRNA-Based Liquid Biopsy Detects Early Pancreatic Cancer – NCIhttps://www.cancer.gov/news-events/cancer-currents-blog/2024/liquid-biopsy-detects-pancreatic-cancer
The most effective and practical use of [this] blood test would be in high-risk individuals, Dr. Goel agreed. That includes people with an inherited genetic mutation that puts them at high risk for pancreatic cancer, people with family members whove had pancreatic cancer, and people with chronic pancreatitis or new-onset diabetes. […] But the test needs to be studied in more detail before it can be used to screen people for pancreatic cancer, said Howard Crawford, Ph. D., scientific director of the Henry Ford Pancreatic Cancer Center in Michigan, who wasnt involved in the study. […] In the Japanese group, or cohort, the microRNA analysis could distinguish between people with and without pancreatic cancer. The test was then validated in the other three cohorts, resulting in an accuracy of 93% in the US cohort, 91% in the Korean cohort, and 88% in the Chinese cohort.
- #1 Diagnosis of pancreatic cancer | Canadian Cancer Societyhttps://cancer.ca/en/cancer-information/cancer-types/pancreatic/diagnosis
Diagnosis is the process of finding out the cause of a health problem. Diagnosing pancreatic cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for pancreatic cancer or other health problems. […] The following tests may be used to rule out or diagnose pancreatic cancer. Many of the same tests used to diagnose cancer are used to find out the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment. […] A physical exam allows your doctor to look for any signs of pancreatic cancer. During a physical exam, your doctor may: check your skin and the whites of your eyes for jaundice, feel your abdomen for any lumps or swelling, feel your abdomen to see if your gallbladder, liver or spleen are larger than normal, check your legs for swelling, check the lymph nodes above your collarbone and in other places to see if they are swollen.
- #1 Pancreatic Cancer Diagnosis and What Goes Into Making It!https://lustgarten.org/living-with-pancreatic-cancer/understanding/what-is-pancreatic-cancer/pancreatic-cancer-diagnosis/
Several steps are involved in making a diagnosis of pancreatic cancer. The first thing your doctor will do is ask questions about your medical and family history, possible risk factors and symptoms. Answering these questions honestly and completely will help both you and your doctor during the diagnostic process. […] A doctor will perform a physical examination and check your abdomen for tenderness, fluid buildup, enlargement of your gallbladder or liver, and masses. Your lymph nodes will be checked for tenderness and swelling, and any sign of jaundice will be noted. Your doctor also may order blood or urine tests, testing of stool samples or imaging tests. […] No single blood test can be used to make a diagnosis of pancreatic cancer yet. When a person has pancreatic cancer, however, elevated levels of bilirubin or liver enzymes may be present.
- #1 Pancreatic Cancer Diagnosis | Memorial Sloan Kettering Cancer Centerhttps://www.mskcc.org/cancer-care/types/pancreatic/diagnosis
A high level can mean theres a tumor blocking the bile duct. […] People with pancreatic cancer often have a higher level in their blood of a protein called CA 19-9. […] Not all types of pancreatic cancer cause higher levels of CA 19-9. Other conditions that are not cancer also can cause a higher level of this protein. […] If you have pancreatic cancer, you will keep having blood tests of your CA 19-9 level. Monitoring the level tells us how well treatment is working, or if cancer came back after treatment. […] Doctors use imaging tests to help find and diagnose disease, recommend treatments, and monitor how well you respond to therapy. […] Imaging tests help us learn more about the tumor. They also can tell us whether cancer cells have spread to nearby tissues or other parts of the body.
- #1 Pancreatic Cancer: Diagnosis and Management | AAFPhttps://www.aafp.org/pubs/afp/issues/2006/0201/p485.html
However, CA 199 lacks sufficient sensitivity (50 to 75 percent) and specificity (83 percent) to effectively screen asymptomatic patients. […] The U.S. Preventive Services Task Force (USPSTF) does not recommend screening average-risk, asymptomatic patients with abdominal palpation, ultrasonography, or serologic tumor markers. […] Although regular screening with endoscopic ultrasonography may be cost-effective in patients with a family history of pancreatic cancer, the USPSTF has not addressed the question of screening these patients. […] Dual-phase helical computed tomography is the best initial imaging test for diagnosis and staging of suspected pancreatic carcinoma. […] Patients undergoing resection for pancreatic cancer should be offered referral to high-volume hospitals (i.e., performing more than 16 Whipple procedures per year) where there is less risk of perioperative mortality.
- #1 Pancreatic Cancer Diagnosis and What Goes Into Making It!https://lustgarten.org/living-with-pancreatic-cancer/understanding/what-is-pancreatic-cancer/pancreatic-cancer-diagnosis/
Two commercially available tumor marker tests are of use in patients with pancreatic cancer: cancer antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA). These markers are not accurate enough to be used to screen healthy people or to make a diagnosis of pancreatic cancer. However, CA 19-9 and CEA are frequently used to track the progress of treatment in patients with pancreatic cancer. […] If blood and urine test results show high levels of bilirubin, it may be an indication of pancreatic cancer. However, many other medical situations can cause an elevation in bilirubin. Additional testing will almost always be needed to confirm a diagnosis of pancreatic cancer. […] Imaging is important to detect pancreatic cancer. These tests use a variety of methods to see inside the body. CT scansâor some variation of a CT scanâof the chest, abdomen, and pelvis are most commonly used in the diagnosis of pancreatic cancer.
- #1 Pancreatic Cancer Diagnosis â Pancreatic Cancer Action Networkhttps://pancan.org/facing-pancreatic-cancer/diagnosis/
A doctor and patient discuss the diagnosis of pancreatic cancer. […] If you have pancreatic cancer symptoms, your doctor must do a few things to see if you have pancreatic cancer. The doctor will: […] To be sure of a pancreatic cancer diagnosis, your doctors must get information from imaging tests and tumor tissue samples. Blood tests can also give them good information. […] An imaging test is used to detect pancreatic cancer. Imaging studies give doctors visual information about the pancreas and surrounding tissues. They are the only way to see a pancreatic tumor. So, imaging tests are critical in diagnosing and monitoring pancreatic cancer. […] While blood tests may signify the possible presence of the disease, they cannot lead to a definitive pancreatic cancer diagnosis. Additional tests, like imaging and biopsies, are necessary to confirm the diagnosis.
- #1 Pancreatic Cancer Imaging: Practice Essentials, Radiography, Computed Tomographyhttps://emedicine.medscape.com/article/370909-overview
The sensitivity of MRCP has been estimated at 84%, with specificity of 97% for pancreatic cancer. Findings are complementary to those of ERCP and percutaneous transhepatic cholangiography (PTC). […] CT is the most widely used and most sensitive test for evaluation of the pancreas for pancreatic carcinoma. Dynamic CT has a detection rate of approximately 99%. Multisection CT should be the first-line study used for detecting this tumor and for evaluating its resectability.
- #1 Pancreatic Cancer Imaging: Practice Essentials, Radiography, Computed Tomographyhttps://emedicine.medscape.com/article/370909-overview
In high-risk patients, MRI and positron emission tomography-computed tomography (PET/CT) may further guide treatment decisions. Some studies comparing CT and MRI have found detection and assessment of resectability to be similar. However, MRI takes longer, costs more, is more complex, and is limited by artifacts. […] If the patient is clinically jaundiced and if biliary ductal dilatation is demonstrated on ultrasonographic (US) examination, endoscopic retrograde cholangiopancreatography (ERCP) is the next investigation of choice, with a view toward a drainage procedure. […] For detection and staging of small tumors, EUS can be reliable when performed by experienced imagers. […] EUS-guided fine-needle aspiration (FNA) is safe and effective, especially for pancreatic head masses. […] MRI is often used as a second-line study in the management of pancreatic adenocarcinoma, reserved for cases where CT results are equivocal or CT with contrast is contraindicated. Compared with other modalities, MRI appears to be more valuable for staging the extent and spread of pancreatic carcinoma than for detecting lesions smaller than 2 cm.
- #1 Diagnosis of pancreatic cancer | Canadian Cancer Societyhttps://cancer.ca/en/cancer-information/cancer-types/pancreatic/diagnosis
Tumour markers are substances found in the blood, tissues or fluids removed from the body. An abnormal amount of a tumour marker may mean that a person has pancreatic cancer. […] A CT scan is the most common imaging test for pancreatic cancer. It is used to: find tumours, find out the size of the tumour, find out if the tumour can be completely removed with surgery, find out if the cancer has spread to nearby organs and tissues, guide a fine needle aspiration (FNA) biopsy to get tissue samples. […] An endoscopic ultrasound (EUS) is a newer procedure that can diagnose pancreatic cancer more accurately than an abdominal ultrasound. […] An MRI is used to find tumours and check to see if the cancer has spread to other organs and tissues. […] ERCP is used to: find a tumour that may be causing a blockage in the bile duct or pancreatic duct, collect a sample for biopsy, place a tube (stent) to relieve the blockage of the bile duct. […] A biopsy is the type of biopsy used to collect a sample from the pancreas. An FNA uses a thin needle and a syringe to remove a small amount of fluid or cells. […] A PET scan is used to: find tumours, find out if cancer has spread to other organs and tissues.
- #1 Pancreatic Cancer Workup: Approach Considerations, Laboratory Findings, Tumor Markershttps://emedicine.medscape.com/article/280605-workup
Evaluation of CA 19-9 levels has been used as an adjunct to imaging studies for helping to determine the resectability potential of pancreatic carcinoma. Fewer than 4% of patients with a CA 19-9 level of more than 300 U/mL have been found to have resectable tumors. […] EUS has been found to have detection rates of 99-100% for all pancreatic carcinomas, including those smaller than 3 cm. EUS is as accurate as ERCP or MRCP for assessing the etiology of obstructive jaundice. […] ERCP is a highly sensitive means of detecting pancreatic and/or biliary ductal abnormalities in pancreatic carcinoma. Among patients with pancreatic adenocarcinoma, 90-95% have abnormalities on ERCP findings. […] The NCCN guidelines recommend multi-detector computed tomography (MDCT) angiography, using a dual-phase pancreatic protocol, as the preferred modality for dedicated pancreatic imaging.
- #1 Pancreatic Cancer Diagnosis â Pancreatic Cancer Action Networkhttps://pancan.org/facing-pancreatic-cancer/diagnosis/
A pathologist looks at a biopsy under a microscope to make a clear pancreatic cancer diagnosis. The only way for your doctor to know if a mass or tumor is cancer is to get a tissue sample, called a biopsy. […] After getting a tumor tissue sample, your doctor may run tests to understand your tumors biological details. This is called tumor biomarker testing. […] No universal screening tests for pancreatic cancer in the general population exist yet. […] When talking to your doctor about your diagnosis, some helpful questions to ask are: What tests and scans will you use to confirm a pancreatic cancer diagnosis? […] A pancreatic cancer diagnosis can be overwhelming, and you may not know what to do next. Being informed helps you make the best decisions for you. […] Knowing details about your diagnosis helps you make decisions. Important things to know include: The type of pancreatic cancer, Your cancers stage, Where the tumors are located, If the cancer has spread, If surgery is possible, Treatment options for your diagnosis.
- #1 Pancreatic Cancer Workup: Approach Considerations, Laboratory Findings, Tumor Markershttps://emedicine.medscape.com/article/280605-workup
Obtaining a cytologic or tissue diagnosis of pancreatic cancer is not necessary prior to surgery. However, a pathologic diagnosis is required before the administration of neoadjuvant therapy and for patients staged with locally advanced pancreatic cancer or metastatic disease. […] EUS-guided FNA has proven to be the most effective means for making a definitive cytologic diagnosis of pancreatic carcinoma. A meta-analysis that included 20 studies and 2761 patients showed that EUS-guided FNA has sensitivity of 90.8% and specificity of 96.5% for diagnosing solid pancreatic lesions. […] Once an imaging modality has helped to establish a probable diagnosis of pancreatic cancer, the next issue is whether the lesion is amenable to surgical resection. Pancreatic masses are characterized as resectable, unresectable, or borderline resectable, on the basis of CT and/or EUS criteria.
- #1 PANCREATIC CANCER DIAGNOSIShttp://pancreatica.org/pancreatic-cancer/pancreatic-cancer-diagnosis/
CT or ultrasound-guided percutaneous biopsy (via needle) can retrieve a bit of pancreatic tumor tissue for histologic (microscopic) viewing without requiring full pancreatic cancer surgery. […] If evidence of unresectability is found, a percutaneous biopsy might be done, to fully establish the diagnosis of the type of pancreatic cancer and to help with medical treatment planning. […] There are no reliable methods to detect the disease early, and there are very few effective treatment options. […] Which is why we are so focused on supporting research for early diagnosis. Together with You our Mission is to promote awareness, increase education, and further pancreatic cancer research aimed at early diagnosis.
- #1 Azthena logo with the word Azthenahttps://www.news-medical.net/health/Pancreatic-Cancer-Diagnosis.aspx
Endoscopic retrograde cholangiopancreatography (ERCP) is another endoscopic procedure used to check for abnormalities of the pancreas. In this procedure, a small amount of dye is injected into the pancreas and bile ducts and an endoscope used to help take an X-ray. A biopsy may be taken at the same time. […] A laparoscopy is a surgical procedure where small cuts are made in the abdomen and a long, thin instrument called a laparoscope is passed through the incisions so that an internal examination can be performed. This procedure helps the doctor to identify any suspicious areas and take a biopsy to send for analysis.
- #1 Pancreatic cancer – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/diagnosis-treatment/drc-20355427
After confirming a diagnosis of pancreatic cancer, your health care team works to find the extent of the cancer. This is called the stage of the cancer. […] The stages of pancreatic cancer use the numbers 0 to 4. […] The Whipple procedure, also called pancreaticoduodenectomy, is an operation to remove the head of the pancreas. […] Research shows that pancreatic cancer surgery tends to cause fewer complications when done by highly experienced surgeons at centers that do many of these operations. […] Chemotherapy might be the first treatment used when the first treatment can’t be surgery. […] Radiation can be used either before or after surgery. […] Immunotherapy is a treatment with medicine that helps the body’s immune system kill cancer cells. […] Clinical trials are studies of new treatments.
- #1 Pancreatic Cancer: Diagnosis and Staginghttps://www.verywellhealth.com/pancreatic-cancer-diagnosis-and-staging-4120198
Imaging tests are usually the primary method of visualizing a pancreatic mass. […] A biopsy (sample of tissue) is usually needed to confirm the diagnosis of pancreatic cancer. This test is also used to look at the molecular characteristics of the tumor. In selected cases, surgery can be done without a biopsy. […] Determining the stage of pancreatic cancer is extremely important when it comes to deciding whether cancer can be surgically removed or not. Staging can also assist in estimating the prognosis of the disease. […] Healthcare providers use a system called TNM staging to determine the stage of a tumor.
- #1 Diagnosis and management of pancreatic cancerhttps://pmc.ncbi.nlm.nih.gov/articles/PMC3787168/
Pancreatic cancer with partial abutment or encasement of the hepatic portal or superior mesenteric veins is considered borderline resectable, and surgery is attempted only if complete resection is possible. […] Patients with advanced pancreatic cancer include those with locally advanced or metastatic disease and have a median overall survival of 23 months without treatment.
- #1 Pancreatic Cancer Workup: Approach Considerations, Laboratory Findings, Tumor Markershttps://emedicine.medscape.com/article/280605-workup
The clinical staging system (Evans et al), which is often used to determine resectability, relies on radiographic evidence of abutment or encasement of vascular structures, and the degree of narrowing of the superior mesenteric vein and/or portal vein, to categorize localized pancreatic cancer as resectable or borderline resectable, and also to define locally advanced unresectable pancreatic cancer.
- #1 Pancreatic Cancer Diagnostic Market Size Report, 2030https://www.grandviewresearch.com/industry-analysis/pancreatic-cancer-diagnostic-market-report
Moreover, the increasing demand for advanced diagnostic solutions has compelled manufacturers to develop novel precise testing solutions. […] Advancements in molecular diagnostics are also creating opportunities in the market. Molecular diagnostic tests can detect specific genetic mutations and biomarkers associated with pancreatic cancer, enabling earlier diagnosis and more precise treatment. […] The imaging test segment dominated the global market with a revenue share of 57.4% in 2022. The segment growth is attributed to its ability to allow healthcare professionals to detect and diagnose pancreatic cancer earlier and help to stage cancer, which can improve treatment outcomes and patient survival rates. […] The market for blood tests is projected to experience robust growth during the forecast period. The segment growth is owing to the rising demand for early diagnosis of malignancies and technological advancements.
- #1 Pancreatic Cancer Diagnosis | Memorial Sloan Kettering Cancer Centerhttps://www.mskcc.org/cancer-care/types/pancreatic/diagnosis
MSK created a genetic test MSK-IMPACT. This next-generation DNA sequencing test looks for mutations in tumor cells. […] Using just a small tissue sample, this advanced sequencing test looks for genetic changes in 505 genes. […] When cancer cells die, they break apart and release their DNA into the blood. […] Liquid biopsies are one of the methods used to support targeted therapy. […] MSK studies this normal tissue, too. We can tell whether you were born with the mutations, or if the mutations happened during your lifetime. […] These inherited mutations are more likely to respond to certain treatments.
- #1 microRNA-Based Liquid Biopsy Detects Early Pancreatic Cancer – NCIhttps://www.cancer.gov/news-events/cancer-currents-blog/2024/liquid-biopsy-detects-pancreatic-cancer
Scientists have developed a blood test that can accurately detect early-stage pancreatic cancer, according to results from a large study. The test is a liquid biopsy, a type of test that uses blood or other bodily fluids to detect or monitor cancer. […] If pancreatic cancer is caught earlier, however, chances of living for 5 years after diagnosis are much higher: 44% for early-stage disease versus 3% for late-stage disease. […] The blood test, developed by Ajay Goel, Ph.D., of City of Hope Duarte Cancer Center in California and his colleagues, analyzes small bits of RNA released by tumors. The new study, which included nearly 1,000 people from several countries, showed that the test accurately detected early- and late-stage pancreatic cancer in a large and diverse group of people. […] And when the researchers combined their blood test with one that detects a protein called CA19-9, the combination accurately identified 97% of people with early-stage pancreatic cancer.
- #1 Advances in biomarkers and techniques for pancreatic cancer diagnosis | Cancer Cell International | Full Texthttps://cancerci.biomedcentral.com/articles/10.1186/s12935-022-02640-9
The DNA methylation of biomarkers for PC detection is displayed in Table 1. […] Noncoding RNAs play important roles in PC development. […] The efficacy of microRNAs in the differential diagnosis of PC from healthy participants is displayed in Table 2. […] Proteomics is based on the study of the full set of proteins and aims to understand all expressed proteins in cells, including their number, level, and renewal. Protein biomarkers related to PC can be detected in the patients blood, pancreatic juice, and tumor tissue. […] Aberrant levels of GPC1, CPA4, C4BPA, PFAA, MUC5AC, and OPNT+TIMP-1 were frequently detected in the serum of PC patients. […] AI has been applied in the field of imaging intelligent diagnosis of pancreatic diseases with significant progress. […] The major difficulty for EUS-AI applications is that different lesions often have similar imaging findings.
- #1 Early screening and diagnosis strategies of pancreatic cancer: a comprehensive reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8696234/
Direct screening of pancreatic cancer patients from the general population is difficult and not cost-effective due to the lack of high specificity tests and the low incidence of pancreatic cancer. The National Comprehensive Cancer Network (NCCN) recommends the application of endoscopic ultrasonography (EUS) for genetic/familial high-risk individuals. However, applying screening strategies for sporadic pancreatic cancer in individuals with one or more risk factors could enhance the performance of a putative screening test. […] When there is clinical suspicion or evidence of dilated pancreatic and/or bile duct, the NCCN guidelines suggest that pancreatic protocol computed tomography (CT) should first be utilized for diagnosis. Additionally, magnetic resonance imaging/cholangiopancreatography (MRI/MRCP), EUS, EUS-guided fine-needle aspiration (EUSFNA), and endoscopic retrograde cholangiopancreatography (ERCP) also play important roles in diagnosing pancreatic cancer. Many technological innovations of imaging or endoscopy are being applied to improve the diagnostic accuracy of pancreatic tumors. […] To date, still no biomarkers or panels of markers with sufficient diagnostic accuracy have been approved for the early diagnosis of pancreatic cancer. Hence, the aim of this review is to discuss current screening and diagnostic strategies and future prospects in terms of risk factors, imaging approaches, pathological examination, serological tests, liquid biopsies, and other novel early diagnostic methods of pancreatic cancer.
- #1 Can Pancreatic Cancer Be Found Early? | Screening for Pancreatic Cancer | American Cancer Societyhttps://www.cancer.org/cancer/types/pancreatic-cancer/detection-diagnosis-staging/detection.html
For people in families at high risk of pancreatic cancer, newer tests for detecting pancreatic cancer early may help. The two most common tests are an endoscopic ultrasound (EUS) or MRI/magnetic resonance cholangiopancreatography (MRCP). […] Doctors have been able to find early, treatable pancreatic cancers in some members of high-risk families with these tests. […] Doctors are also studying other new tests to try to find pancreatic cancer early.
- #1 Diagnosis and Management of Pancreatic Cancer | AAFPhttps://www.aafp.org/pubs/afp/issues/2014/0415/p626.html
Pancreatic cancer remains the fourth leading cause of cancer-related deaths in the United States. […] In symptomatic patients, the serum tumor marker cancer antigen 19-9 can be used to confirm the diagnosis and to predict prognosis and recurrence after resection. Pancreas protocol computed tomography is considered standard for the diagnosis and staging of pancreatic cancer. […] The differential diagnosis of suspected pancreatic cancer is broad given the wide range of nonspecific symptoms. […] More than 90% of these cancers are ductal adenocarcinomas, with more than two-thirds occurring in the head of the pancreas. […] For many patients presenting with the common symptoms of pancreatic cancer, abdominal ultrasonography is a reasonable first imaging test. However, if ultrasonography is not diagnostic or pancreatic cancer is highly suggested by findings on the clinical examination, then pancreas protocol CT is the standard for diagnosis and staging.
- #1 Pancreatic Cancer Early Detection â Pancreatic Cancer Action Networkhttps://pancan.org/facing-pancreatic-cancer/diagnosis/early-detection/
Pancreatic cancer is hard to diagnose early. There is no standard diagnostic tool or established early detection method for pancreatic cancer in the general population yet. However, there are imaging and blood-based tests that may be able to detect pancreatic cancer in its early stages in people who are at an increased risk for the disease. […] Researchers across the world are working to develop early detection methods for pancreatic cancer. Those at high risk may consider research studies like surveillance programs. These programs use regular monitoring to look for the disease with the hope of finding it earlier if it does develop. […] Patients whose disease is diagnosed in its early stages have better outcomes. This is due to access to more treatment options, including surgery. […] Ways to find pancreatic cancer in the earliest stages are urgently needed. The Pancreatic Cancer Action Network, other advocacy organizations and the scientific community are working to find pancreatic cancer earlier through: Awareness of symptoms, Efforts to improve imaging, Studies focused on biomarkers (biological clues) that could help doctors diagnose, monitor and treat the disease, Efforts to improve how people at high risk are found and monitored.
- #2 Can Pancreatic Cancer Be Found Early? | Screening for Pancreatic Cancer | American Cancer Societyhttps://www.cancer.org/cancer/types/pancreatic-cancer/detection-diagnosis-staging/detection.html
Pancreatic cancer is hard to find early. The pancreas is deep inside the body, so early tumors cant be seen or felt by health care providers during routine physical exams. People usually have no symptoms until the cancer has become very large or has already spread to other organs. […] For certain types of cancer, screening tests or exams are used to look for cancer in people who have no symptoms (and who have not had that cancer before). But for pancreatic cancer, no major professional groups currently recommend routine screening in people who are at average risk. This is because no screening test has been shown to lower the risk of dying from this cancer. […] Knowing if you are at increased risk can help you and your doctor decide if you should have tests to look for pancreatic cancer early, when it might be easier to treat.
- #2 Imaging Tests for the Diagnosis and Staging of Pancreatic Adenocarcinoma | Effective Health Care (EHC) Programhttps://effectivehealthcare.ahrq.gov/products/cancer-pancreas/research-protocol
Pancreatic cancer is the fourth most common cause of cancer death among men and women in the United States. In 2013, about 45,000 people in the United States will receive a diagnosis of pancreatic cancer, and 38,000 will die of the disease. The most common type of pancreatic cancer is adenocarcinoma (approximately 90% of all pancreatic malignancies). Screening for pancreatic adenocarcinoma is not recommended for the general population (e.g., the U.S. Preventive Services Task Force gives it a D recommendation). However, some professional organizations recommend screening those who are at high risk of developing pancreatic cancer. This review concerns imaging tests to identify and diagnose suspected pancreatic cancer and to determine stage and surgical resectability of the disease. Patients often remain asymptomatic or have only nonspecific symptoms such as malaise, fatigue, and loss of appetite until late in the course of the diseaseoften after it has spread extensivelywhen weight loss, jaundice, and severe abdominal pain often appear. Due to late diagnosis, approximately 80 to 85 percent of cases are unresectable (i.e., too advanced to permit surgical resection), and the median survival of patients with unresectable tumors is only 6 to 10 months. Common symptoms leading to suspicion of pancreatic cancer are jaundice, epigastric pain, and weight loss. Signs and symptoms alone, however, are insufficient to diagnose pancreatic cancer. Thus, additional clinical informationincluding imaging tests, laboratory values, and biopsiesare important to differentiate these conditions from pancreatic cancer. Multidetector computed tomography (MDCT) scan is often the first imaging test in a patient whose symptoms suggest pancreatic adenocarcinoma. Other procedures and imaging tests are also used to aid diagnosis of pancreatic adenocarcinoma, including endoscopic ultrasound with fine-needle aspiration (EUS-FNA), positron emission tomography-computed tomography (PET-CT), and magnetic resonance imaging (MRI). Once pancreatic adenocarcinoma is diagnosed, the stage of disease is a key determinant of clinical management, as well as a key predictor of survival. Most cases are diagnosed at an advanced stage, precluding surgical resection. For localized disease, the 5-year survival is approximately 22 percent. When pancreatic adenocarcinoma is diagnosed at an advanced stage, the 5-year survival is approximately 2 percent. Surgical resection offers the only hope of cure and is decided via multidisciplinary consultation. The two key factors in assessing resectability are distant metastasis (which usually indicate unresectability) and blood vessel involvement (which sometimes indicates unresectability, depending on the degree of involvement).
- #2 Diagnosis of pancreatic cancer | Canadian Cancer Societyhttps://cancer.ca/en/cancer-information/cancer-types/pancreatic/diagnosis
Tumour markers are substances found in the blood, tissues or fluids removed from the body. An abnormal amount of a tumour marker may mean that a person has pancreatic cancer. […] A CT scan is the most common imaging test for pancreatic cancer. It is used to: find tumours, find out the size of the tumour, find out if the tumour can be completely removed with surgery, find out if the cancer has spread to nearby organs and tissues, guide a fine needle aspiration (FNA) biopsy to get tissue samples. […] An endoscopic ultrasound (EUS) is a newer procedure that can diagnose pancreatic cancer more accurately than an abdominal ultrasound. […] An MRI is used to find tumours and check to see if the cancer has spread to other organs and tissues. […] ERCP is used to: find a tumour that may be causing a blockage in the bile duct or pancreatic duct, collect a sample for biopsy, place a tube (stent) to relieve the blockage of the bile duct. […] A biopsy is the type of biopsy used to collect a sample from the pancreas. An FNA uses a thin needle and a syringe to remove a small amount of fluid or cells. […] A PET scan is used to: find tumours, find out if cancer has spread to other organs and tissues.
- #2 Diagnosis of pancreatic cancer | Canadian Cancer Societyhttps://cancer.ca/en/cancer-information/cancer-types/pancreatic/diagnosis
Diagnosis is the process of finding out the cause of a health problem. Diagnosing pancreatic cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for pancreatic cancer or other health problems. […] The following tests may be used to rule out or diagnose pancreatic cancer. Many of the same tests used to diagnose cancer are used to find out the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment. […] A physical exam allows your doctor to look for any signs of pancreatic cancer. During a physical exam, your doctor may: check your skin and the whites of your eyes for jaundice, feel your abdomen for any lumps or swelling, feel your abdomen to see if your gallbladder, liver or spleen are larger than normal, check your legs for swelling, check the lymph nodes above your collarbone and in other places to see if they are swollen.
- #2 Pancreatic Cancer Diagnosis and What Goes Into Making It!https://lustgarten.org/living-with-pancreatic-cancer/understanding/what-is-pancreatic-cancer/pancreatic-cancer-diagnosis/
Several steps are involved in making a diagnosis of pancreatic cancer. The first thing your doctor will do is ask questions about your medical and family history, possible risk factors and symptoms. Answering these questions honestly and completely will help both you and your doctor during the diagnostic process. […] A doctor will perform a physical examination and check your abdomen for tenderness, fluid buildup, enlargement of your gallbladder or liver, and masses. Your lymph nodes will be checked for tenderness and swelling, and any sign of jaundice will be noted. Your doctor also may order blood or urine tests, testing of stool samples or imaging tests. […] No single blood test can be used to make a diagnosis of pancreatic cancer yet. When a person has pancreatic cancer, however, elevated levels of bilirubin or liver enzymes may be present.
- #2 Advances in biomarkers and techniques for pancreatic cancer diagnosis | Cancer Cell International | Full Texthttps://cancerci.biomedcentral.com/articles/10.1186/s12935-022-02640-9
Serum molecules, including CA19-9, CA125, and CEA, are widely used tumor markers for routine PC detection. Serum marker detection is superior to the abovementioned traditional methods in terms of high reproducibility, good patient compliance, easy follow-up, and low cost. […] However, CA19-9 is not tumor type-specific because of its elevation in other malignancies, including colorectal cancer, cholangiocarcinoma, hepatocarcinoma, gastric cancer, and even benign diseases, such as obstructive jaundice, cirrhosis, cholangitis, and other gastrointestinal diseases. […] Notably, a high CA19-9 level usually suggests advanced PC instead of early-stage PC, especially for tumors with a diameter less than 3 cm. […] The detection of DNA methylation in peripheral blood is prevalent for PC diagnosis.
- #2 Tests for pancreatic cancer – Pancreatic Cancer UKhttps://www.pancreaticcancer.org.uk/information/how-is-pancreatic-cancer-diagnosed/tests-for-pancreatic-cancer/
You may need several tests to work out whats causing your symptoms. If you are diagnosed with pancreatic cancer, you may then need more tests. These will help to find out the exact type of pancreatic cancer and what stage it is. Your doctors will use all the test results to help decide the best treatment and care for you. […] These tests are used to help diagnose pancreatic cancer. You may not need all these tests, and you may not have them in this order. […] Blood tests can also check for chemical substances produced by cancers called tumour markers. CA19-9 is a marker that may be used to help diagnose pancreatic cancer. But not all pancreatic cancers produce tumour markers, and illnesses that are not cancer can also produce them. The doctors may test for CA19-9, but it wont diagnose cancer. If you are diagnosed with pancreatic cancer, it is sometimes used to monitor the cancer during treatment.
- #2 PANCREATIC CANCER DIAGNOSIShttp://pancreatica.org/pancreatic-cancer/pancreatic-cancer-diagnosis/
The main reason for the diagnostic staging of pancreatic cancer is to try to chart the best course for treatment, especially to help decide whether a patient is a candidate for surgical resection. […] Generally, in the U.S., the dynamic spiral (or helical) CT scan with IV and oral contrast media enhancement is considered to be the procedure of choice for the diagnosis / staging of pancreatic cancer. […] With the latest equipment and with experienced operators and evaluators, this approach at diagnosis can detect up to 90-95% of cancer of the pancreas. […] Specific pancreatic cancer tumors that are greater than to one inch in diameter can usually be detected. […] Transabdominal ultrasound is a more popular diagnostic procedure for pancreatic cancer outside of the U.S. where operators are more experienced and generally the patient-population may be less obese a big problem in imaging structures through the abdomen. […] The endoscopic ultrasound (ultrasound through a tube which is placed down the esophagus) can be very good at finding small tumors in the pancreas.
- #2 Pancreatic Cancer Imaging: Practice Essentials, Radiography, Computed Tomographyhttps://emedicine.medscape.com/article/370909-overview
The sensitivity of MRCP has been estimated at 84%, with specificity of 97% for pancreatic cancer. Findings are complementary to those of ERCP and percutaneous transhepatic cholangiography (PTC). […] CT is the most widely used and most sensitive test for evaluation of the pancreas for pancreatic carcinoma. Dynamic CT has a detection rate of approximately 99%. Multisection CT should be the first-line study used for detecting this tumor and for evaluating its resectability.
- #2 Pancreatic Cancer Diagnosis | Virginia Cancer Specialistshttps://www.virginiacancerspecialists.com/disease/pancreatic-cancer/pancreatic-cancer-diagnosis/
Ultrasound: Your doctor places the ultrasound device on your abdomen and slowly moves it around. The ultrasound device uses sound waves that canât be heard by humans. The sound waves make a pattern of echoes as they bounce off internal organs. The echoes create a picture of your pancreas and other organs in the abdomen. The picture may show a tumor or blocked ducts. […] EUS: Your doctor passes a thin, lighted tube (endoscope) down your throat, through your stomach, and into the first part of the small intestine. An ultrasound probe at the end of the tube sends out sound waves that you canât hear. The waves bounce off tissues in your pancreas and other organs. As your doctor slowly withdraws the probe from the intestine toward the stomach, the computer creates a picture of the pancreas from the echoes. The picture can show a tumor in the pancreas. It can also show how deeply the cancer has invaded the blood vessels.
- #2 Pancreatic Cancer Workup: Approach Considerations, Laboratory Findings, Tumor Markershttps://emedicine.medscape.com/article/280605-workup
Evaluation of CA 19-9 levels has been used as an adjunct to imaging studies for helping to determine the resectability potential of pancreatic carcinoma. Fewer than 4% of patients with a CA 19-9 level of more than 300 U/mL have been found to have resectable tumors. […] EUS has been found to have detection rates of 99-100% for all pancreatic carcinomas, including those smaller than 3 cm. EUS is as accurate as ERCP or MRCP for assessing the etiology of obstructive jaundice. […] ERCP is a highly sensitive means of detecting pancreatic and/or biliary ductal abnormalities in pancreatic carcinoma. Among patients with pancreatic adenocarcinoma, 90-95% have abnormalities on ERCP findings. […] The NCCN guidelines recommend multi-detector computed tomography (MDCT) angiography, using a dual-phase pancreatic protocol, as the preferred modality for dedicated pancreatic imaging.
- #2 Tests for Pancreatic Cancer | Diagnosing Pancreatic Cancer | American Cancer Societyhttps://www.cancer.org/cancer/types/pancreatic-cancer/detection-diagnosis-staging/how-diagnosed.html
If a person has signs and symptoms that might be caused by pancreatic cancer, certain exams and tests will be done to find the cause. If cancer is found, more tests will be done to help determine the extent (stage) of the cancer. […] Your doctor will ask about your medical history to learn more about your symptoms. They might also ask about possible risk factors, including smoking and your family history. […] Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests might be done for many reasons both before and after a diagnosis of pancreatic cancer, including: To look for suspicious areas that might be cancer. […] The CT scan makes detailed cross-sectional images of your body. CT scans are often used to diagnose pancreatic cancer because they can show the pancreas fairly clearly.
- #2 Pancreatic Cancer Diagnosis | Memorial Sloan Kettering Cancer Centerhttps://www.mskcc.org/cancer-care/types/pancreatic/diagnosis
A CT scan can show where a tumor is located, its size, and if it has spread outside of your pancreas. […] MRI is different from a CT scan. It uses radio waves, a powerful magnet, and a computer to take pictures. […] During your EUS, your doctor may also do a biopsy procedure to take a sample. […] A biopsy is a procedure to take a tissue sample from the pancreas. […] A doctor called a pathologist will examine the tissue sample under a microscope. They will tell the type of tumor and whether its benign (not cancer) or malignant (cancer). […] MSK uses very precise imaging methods to guide biopsy procedures. This lets us examine cysts and tumors in areas of the body that were impossible to reach safely before. […] Tumor genetic profiling tests show whether cancer is caused by genetic changes. We can choose drugs that target the molecular changes in a tumor.
- #2 Pancreatic Cancer Workup: Approach Considerations, Laboratory Findings, Tumor Markershttps://emedicine.medscape.com/article/280605-workup
Obtaining a cytologic or tissue diagnosis of pancreatic cancer is not necessary prior to surgery. However, a pathologic diagnosis is required before the administration of neoadjuvant therapy and for patients staged with locally advanced pancreatic cancer or metastatic disease. […] EUS-guided FNA has proven to be the most effective means for making a definitive cytologic diagnosis of pancreatic carcinoma. A meta-analysis that included 20 studies and 2761 patients showed that EUS-guided FNA has sensitivity of 90.8% and specificity of 96.5% for diagnosing solid pancreatic lesions. […] Once an imaging modality has helped to establish a probable diagnosis of pancreatic cancer, the next issue is whether the lesion is amenable to surgical resection. Pancreatic masses are characterized as resectable, unresectable, or borderline resectable, on the basis of CT and/or EUS criteria.
- #2 Pancreatic cancer – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/diagnosis-treatment/drc-20355427
After confirming a diagnosis of pancreatic cancer, your health care team works to find the extent of the cancer. This is called the stage of the cancer. […] The stages of pancreatic cancer use the numbers 0 to 4. […] The Whipple procedure, also called pancreaticoduodenectomy, is an operation to remove the head of the pancreas. […] Research shows that pancreatic cancer surgery tends to cause fewer complications when done by highly experienced surgeons at centers that do many of these operations. […] Chemotherapy might be the first treatment used when the first treatment can’t be surgery. […] Radiation can be used either before or after surgery. […] Immunotherapy is a treatment with medicine that helps the body’s immune system kill cancer cells. […] Clinical trials are studies of new treatments.
- #2 Pancreatic Cancer: Symptoms, Causes & Treatmenthttps://my.clevelandclinic.org/health/diseases/15806-pancreatic-cancer
Healthcare providers rank pancreatic tumors into four different categories: Resectable, Borderline resectable, Locally advanced, Metastatic. […] Even though pancreatic cancer has a poor survival rate, complete remission is possible with early detection and treatment. […] Specific treatment depends on certain factors, including the exact location of the tumor, what stage it is, your overall health, and whether the cancer has spread beyond your pancreas. […] Surgery is the only realistic way to cure pancreatic cancer. […] Healthcare providers commonly use this approach to treat pancreatic cancer. […] In the United States, the five-year survival rate for people with pancreatic cancer is 11%.
- #2 Diagnosis & Tests for Pancreatic Cancer | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)https://www.yourcancercare.com/types-of-cancer/pancreatic-cancer/diagnosis-tests-for-pancreatic-cancer
The purpose of precision cancer medicine is to define the genomic alterations in the cancers DNA that are driving that specific cancer so a targeted therapy can be designed to attack a specific mutation or other cancer-related change in the DNA programming of the cancer cells. […] Patients with pancreatic cancer should undergo genomic biomarker testing for the BRCA gene and other markers because pancreatic can be treated with novel precision cancer medicines.
- #2 microRNA-Based Liquid Biopsy Detects Early Pancreatic Cancer – NCIhttps://www.cancer.gov/news-events/cancer-currents-blog/2024/liquid-biopsy-detects-pancreatic-cancer
Scientists have developed a blood test that can accurately detect early-stage pancreatic cancer, according to results from a large study. The test is a liquid biopsy, a type of test that uses blood or other bodily fluids to detect or monitor cancer. […] If pancreatic cancer is caught earlier, however, chances of living for 5 years after diagnosis are much higher: 44% for early-stage disease versus 3% for late-stage disease. […] The blood test, developed by Ajay Goel, Ph.D., of City of Hope Duarte Cancer Center in California and his colleagues, analyzes small bits of RNA released by tumors. The new study, which included nearly 1,000 people from several countries, showed that the test accurately detected early- and late-stage pancreatic cancer in a large and diverse group of people. […] And when the researchers combined their blood test with one that detects a protein called CA19-9, the combination accurately identified 97% of people with early-stage pancreatic cancer.
- #2 Advances in biomarkers and techniques for pancreatic cancer diagnosis | Cancer Cell International | Full Texthttps://cancerci.biomedcentral.com/articles/10.1186/s12935-022-02640-9
AI attempts to use computer models for pancreatic cytological diagnosis, especially on samples from endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA). […] AI can also be applied for the analysis of biological markers. […] Novel nanomaterial components are believed to act as a powerful tool for improving the sensitivity and specificity of early-stage cancer detection. […] The addition of novel designed nanoparticles (NPs) to contrast agents could overcome the limitations of first-generation organic contrast agents by increasing sensitivity through better biodistribution. […] The question of how to diagnose PC earlier is always a motivation for researchers. Screens for early-stage PC need more sensitive and tumor-type specific biomarkers.
- #2 Early screening and diagnosis strategies of pancreatic cancer: a comprehensive reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8696234/
Direct screening of pancreatic cancer patients from the general population is difficult and not cost-effective due to the lack of high specificity tests and the low incidence of pancreatic cancer. The National Comprehensive Cancer Network (NCCN) recommends the application of endoscopic ultrasonography (EUS) for genetic/familial high-risk individuals. However, applying screening strategies for sporadic pancreatic cancer in individuals with one or more risk factors could enhance the performance of a putative screening test. […] When there is clinical suspicion or evidence of dilated pancreatic and/or bile duct, the NCCN guidelines suggest that pancreatic protocol computed tomography (CT) should first be utilized for diagnosis. Additionally, magnetic resonance imaging/cholangiopancreatography (MRI/MRCP), EUS, EUS-guided fine-needle aspiration (EUSFNA), and endoscopic retrograde cholangiopancreatography (ERCP) also play important roles in diagnosing pancreatic cancer. Many technological innovations of imaging or endoscopy are being applied to improve the diagnostic accuracy of pancreatic tumors. […] To date, still no biomarkers or panels of markers with sufficient diagnostic accuracy have been approved for the early diagnosis of pancreatic cancer. Hence, the aim of this review is to discuss current screening and diagnostic strategies and future prospects in terms of risk factors, imaging approaches, pathological examination, serological tests, liquid biopsies, and other novel early diagnostic methods of pancreatic cancer.
- #2 How do Doctors Test for Pancreatic Cancer? – Let’s Win Pancreatic Cancerhttps://letswinpc.org/treatments/diagnosis-pancreatic-cancer-tests-to-expect/
While these are not the only available tests for pancreatic cancer screening, they tend to be doctors top choices. […] Health authorities, including the American Cancer Society, do not recommend pancreatic cancer screening for the general population. […] However, people who have certain genetic mutations (BRCA1, BRCA2, STK11, CDK2NA, PRSS1 and Lynch syndrome, among others), and those who have two or more blood relatives with the disease may benefit from annual pancreatic cancer screening. […] People with pancreatic cysts may also benefit from annual screening. […] According to Anand, high-risk patients often alternate between EUS and MRCP on an annual basis. […] Unfortunately, both of these tests can result in false positives. […] These screening exams offer the best odds of finding pancreatic cancer early, when its most treatable.
- #2 Can Pancreatic Cancer Be Found Early? | Screening for Pancreatic Cancer | American Cancer Societyhttps://www.cancer.org/cancer/types/pancreatic-cancer/detection-diagnosis-staging/detection.html
For people in families at high risk of pancreatic cancer, newer tests for detecting pancreatic cancer early may help. The two most common tests are an endoscopic ultrasound (EUS) or MRI/magnetic resonance cholangiopancreatography (MRCP). […] Doctors have been able to find early, treatable pancreatic cancers in some members of high-risk families with these tests. […] Doctors are also studying other new tests to try to find pancreatic cancer early.
- #2 Diagnosis and Management of Pancreatic Cancer | AAFPhttps://www.aafp.org/pubs/afp/issues/2014/0415/p626.html
The most common serum tumor marker used for pancreatic ductal adenocarcinomas is cancer antigen 19-9, which is expressed in pancreatic and hepatobiliary disease. In symptomatic patients, it can help confirm the diagnosis and predict prognosis and recurrence after resection. […] Detection of pancreatic cancer at an early stage is critical to curative treatment. […] Once a mass is identified and fine-needle aspiration confirms the diagnosis, endoscopic ultrasonography can determine tumor size and extent of lymph node metastases, and assess for portal venous system involvement to complete staging. […] Surgical resection is the only potentially curative treatment for pancreatic ductal adenocarcinomas. […] The decision on resectability requires a multidisciplinary consultation, and distinction should be made between tumors that are resectable, borderline resectable, or unresectable.
- #3 Pancreatic Cancer | Symptoms, Diagnosis & Treatment | MD Anderson Cancer Centerhttps://www.mdanderson.org/cancer-types/pancreatic-cancer.html
Pancreatic cancer occurs when cancer cells form and grow within the pancreas. These tumors are hard to diagnose early, since pancreatic cancer signs and symptoms aren’t obvious. Because of this, the majority of these cancers are diagnosed after the disease has reached an advanced stage, when treatment options are limited. […] About 80% of pancreatic cancers are diagnosed after the disease has reached an advanced stage, which makes them hard to treat. Less than 20% of pancreatic cancers are caught when the cancer is still confined to the pancreas or closely surrounding areas. […] MD Anderson conducts a wide range of clinical trials to test new and innovative treatment options for both localized and metastatic pancreatic cancer. The treatment options used in these trials often cannot be found anywhere else and are critical for advancing pancreatic cancer treatment. […] Current clinical trials focus on detecting pancreatic cancer earlier (especially in patients with risk factors).
- #3 Pancreatic cancer – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421
If your doctors think you may have pancreatic cancer, they may recommend one or more diagnostic tests. For instance, imaging tests like an ultrasound, CT scan, MRI, or PET scan, can help your doctor see a clearer picture of your internal organs. […] Sometimes pancreatic cancer can shed specific proteins called tumor markers in your blood. So your doctors may request blood tests to identify elevation of these markers, one of which is called CA 19-9. If a diagnosis is confirmed, the next step is to determine the extent or stage of the cancer. The stages are numbered one through four and may need to be determined by additional testing. […] Most pancreatic cancer begins in the cells that line the ducts of the pancreas. This type of cancer is called pancreatic ductal adenocarcinoma or pancreatic exocrine cancer. […] Pancreatic cancer rarely is found at its early stages when the chance of curing it is greatest. This is because it often doesn’t cause symptoms until after it has spread to other organs.
- #3 Diagnosis of pancreatic cancer | Canadian Cancer Societyhttps://cancer.ca/en/cancer-information/cancer-types/pancreatic/diagnosis
Diagnosis is the process of finding out the cause of a health problem. Diagnosing pancreatic cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for pancreatic cancer or other health problems. […] The following tests may be used to rule out or diagnose pancreatic cancer. Many of the same tests used to diagnose cancer are used to find out the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment. […] A physical exam allows your doctor to look for any signs of pancreatic cancer. During a physical exam, your doctor may: check your skin and the whites of your eyes for jaundice, feel your abdomen for any lumps or swelling, feel your abdomen to see if your gallbladder, liver or spleen are larger than normal, check your legs for swelling, check the lymph nodes above your collarbone and in other places to see if they are swollen.
- #3 Diagnosis and management of pancreatic cancerhttps://pmc.ncbi.nlm.nih.gov/articles/PMC3787168/
A latency period of about 10 years between the start of pancreatic carcinogenesis and symptomatic disease has been shown. Thus, there is a theoretical benefit to screening; however, there is no consensus as to its optimal modality, interval or duration. […] The pancreas is located in the retroperitoneum, where initial growth of the cancer is silent; therefore, symptoms are usually a sign of advanced disease. Clinical presentation depends on the stage of disease and the location of the primary tumour. […] Tumour markers have minimal diagnostic utility in pancreatic cancer. Biomarkers that have been evaluated include CA 19-9, which has poor positive predictive value in both asymptomatic and symptomatic patients, and carcinoembryonic antigen, which also has a low diagnostic yield. […] The putative diagnosis and stage of pancreatic cancer is usually made with triphasic contrast-enhanced abdominal CT, which provides orientation of the tumour with surrounding vessels and organs.
- #3 Diagnosis of pancreatic cancer | Canadian Cancer Societyhttps://cancer.ca/en/cancer-information/cancer-types/pancreatic/diagnosis
Tumour markers are substances found in the blood, tissues or fluids removed from the body. An abnormal amount of a tumour marker may mean that a person has pancreatic cancer. […] A CT scan is the most common imaging test for pancreatic cancer. It is used to: find tumours, find out the size of the tumour, find out if the tumour can be completely removed with surgery, find out if the cancer has spread to nearby organs and tissues, guide a fine needle aspiration (FNA) biopsy to get tissue samples. […] An endoscopic ultrasound (EUS) is a newer procedure that can diagnose pancreatic cancer more accurately than an abdominal ultrasound. […] An MRI is used to find tumours and check to see if the cancer has spread to other organs and tissues. […] ERCP is used to: find a tumour that may be causing a blockage in the bile duct or pancreatic duct, collect a sample for biopsy, place a tube (stent) to relieve the blockage of the bile duct. […] A biopsy is the type of biopsy used to collect a sample from the pancreas. An FNA uses a thin needle and a syringe to remove a small amount of fluid or cells. […] A PET scan is used to: find tumours, find out if cancer has spread to other organs and tissues.
- #3 Pancreatic Cancer Workup: Approach Considerations, Laboratory Findings, Tumor Markershttps://emedicine.medscape.com/article/280605-workup
Evaluation of CA 19-9 levels has been used as an adjunct to imaging studies for helping to determine the resectability potential of pancreatic carcinoma. Fewer than 4% of patients with a CA 19-9 level of more than 300 U/mL have been found to have resectable tumors. […] EUS has been found to have detection rates of 99-100% for all pancreatic carcinomas, including those smaller than 3 cm. EUS is as accurate as ERCP or MRCP for assessing the etiology of obstructive jaundice. […] ERCP is a highly sensitive means of detecting pancreatic and/or biliary ductal abnormalities in pancreatic carcinoma. Among patients with pancreatic adenocarcinoma, 90-95% have abnormalities on ERCP findings. […] The NCCN guidelines recommend multi-detector computed tomography (MDCT) angiography, using a dual-phase pancreatic protocol, as the preferred modality for dedicated pancreatic imaging.
- #3 Pancreatic Cancer Diagnosis | Virginia Cancer Specialistshttps://www.virginiacancerspecialists.com/disease/pancreatic-cancer/pancreatic-cancer-diagnosis/
Some doctors use the following tests also: […] ERCP: The doctor passes an endoscope through your mouth and stomach, down into the first part of your small intestine. Your doctor slips a smaller tube through the endoscope into the bile ducts and pancreatic ducts. After injecting dye through the smaller tube into the ducts, the doctor takes x-ray pictures. The x-rays can show whether the ducts are narrowed or blocked by a tumor or other condition. […] MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your body. […] PET scan: Youâll receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan may show a tumor in the pancreas. It can also show cancer that has spread to other parts of the body.
- #3 microRNA-Based Liquid Biopsy Detects Early Pancreatic Cancer – NCIhttps://www.cancer.gov/news-events/cancer-currents-blog/2024/liquid-biopsy-detects-pancreatic-cancer
Scientists have developed a blood test that can accurately detect early-stage pancreatic cancer, according to results from a large study. The test is a liquid biopsy, a type of test that uses blood or other bodily fluids to detect or monitor cancer. […] If pancreatic cancer is caught earlier, however, chances of living for 5 years after diagnosis are much higher: 44% for early-stage disease versus 3% for late-stage disease. […] The blood test, developed by Ajay Goel, Ph.D., of City of Hope Duarte Cancer Center in California and his colleagues, analyzes small bits of RNA released by tumors. The new study, which included nearly 1,000 people from several countries, showed that the test accurately detected early- and late-stage pancreatic cancer in a large and diverse group of people. […] And when the researchers combined their blood test with one that detects a protein called CA19-9, the combination accurately identified 97% of people with early-stage pancreatic cancer.
- #3 Advances in biomarkers and techniques for pancreatic cancer diagnosis | Cancer Cell International | Full Texthttps://cancerci.biomedcentral.com/articles/10.1186/s12935-022-02640-9
AI attempts to use computer models for pancreatic cytological diagnosis, especially on samples from endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA). […] AI can also be applied for the analysis of biological markers. […] Novel nanomaterial components are believed to act as a powerful tool for improving the sensitivity and specificity of early-stage cancer detection. […] The addition of novel designed nanoparticles (NPs) to contrast agents could overcome the limitations of first-generation organic contrast agents by increasing sensitivity through better biodistribution. […] The question of how to diagnose PC earlier is always a motivation for researchers. Screens for early-stage PC need more sensitive and tumor-type specific biomarkers.
- #4 PANCREATIC CANCER DIAGNOSIShttp://pancreatica.org/pancreatic-cancer/pancreatic-cancer-diagnosis/
The main reason for the diagnostic staging of pancreatic cancer is to try to chart the best course for treatment, especially to help decide whether a patient is a candidate for surgical resection. […] Generally, in the U.S., the dynamic spiral (or helical) CT scan with IV and oral contrast media enhancement is considered to be the procedure of choice for the diagnosis / staging of pancreatic cancer. […] With the latest equipment and with experienced operators and evaluators, this approach at diagnosis can detect up to 90-95% of cancer of the pancreas. […] Specific pancreatic cancer tumors that are greater than to one inch in diameter can usually be detected. […] Transabdominal ultrasound is a more popular diagnostic procedure for pancreatic cancer outside of the U.S. where operators are more experienced and generally the patient-population may be less obese a big problem in imaging structures through the abdomen. […] The endoscopic ultrasound (ultrasound through a tube which is placed down the esophagus) can be very good at finding small tumors in the pancreas.
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