中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码
引用本文:
Citation:

早期胰腺癌分子诊断专家共识(2023年版)

DOI: 10.12449/JCH240306
基金项目: 

国家自然科学基金 (81770846);

国家自然科学基金 (81642006);

Hirshberg胰腺癌研究基金 (AH201901083);

康德生物癌症研究基金 (KD2021030001)

利益冲突声明:本文不存在任何利益冲突。

Expert consensus on the molecular diagnosis of early-stage pancreatic cancer (2023 edition)

Research funding: 

Natural National Science Foundation of China (81770846);

Natural National Science Foundation of China (81642006);

U.S. Hirshberg Foundation for Pancreatic Cancer Research (AH201901083);

Kante Seeds Grant Foundation for Cancer Research (KD2021030001)

  • 摘要: 胰腺癌是一种较为常见的消化系统肿瘤,早期诊断困难,恶性程度极高。以肿瘤生物标志物为核心的分子辅助诊断技术,结合现有临床金标准,对于实现早期精准检测、及时治疗干预及降低病死率具有重要的临床意义。研究证实,微小RNA(miRNA)在胰腺肿瘤不同病理时期出现的种类和表达量变化呈现高度特异性,可用于胰腺肿瘤发生、发展的全程监测。单个miRNA的诊断潜力有限,miRNA组合或可有效提升对早期胰腺癌变的诊断性能。本共识基于近年相关研究进展,填补胰腺癌临床诊疗指南中关于分子诊断技术的空白,并提供专家指导意见。

     

  • 表  1  GRADE分级系统

    Table  1.   Grading of recommendations assessment, development and evaluation

    类别 分级 定义
    证据质量分级 非常有把握观察值接近真实值
    对观察值有中等把握:观察值有可能接近真实值,但也有可能差别很大
    对观察值的把握有限:观察值可能与真实值有很大差别
    极低 对观察值几乎没有把握:观察值与真实值可能有极大差别
    推荐强度分级 有1项或多项高质量的随机对照研究回答该临床问题
    针对该问题,有设计良好的临床研究但样本量小于500
    专家委员会的报告或观点,以及权威专家的临床经验,提示本领域需进行高质量的临床研究
    下载: 导出CSV

    表  2  胰腺癌高频突变基因

    Table  2.   High frequency mutant genes of pancreatic cancer

    基因 功能 突变频率
    KRAS 原癌基因,调控细胞生长分化 >95%
    TP53 抑癌基因,细胞凋亡及分化 50%~75%
    CDKN2A/p16INK4 抑癌基因,调节细胞周期 95%~98%
    DPC4/SMAD4 抑癌基因,参与细胞凋亡 50%
    BRCA1 抑癌基因,参与双链DNA的断裂修复 15%
    BRCA2 抑癌基因,参与双链DNA的断裂修复 17%
    PALB2 抑癌基因,参与双链DNA的断裂修复 5%
    注:BRCA,乳腺癌易感基因;PALB2,BRCA2定位协作基因。
    下载: 导出CSV

    表  3  胰腺癌阳性患者4个miRNA联合检测结果

    Table  3.   Results of combined detection of 4 miRNAs in pancreatic cancer-positive patients

    4个miRNA联合检测 病理学诊断 合计(例)
    阳性(例) 阴性(例)
    阳性(例) 720 26 746
    阴性(例) 21 539 560
    合计(例) 741 565 1 306
    下载: 导出CSV
  • [1] ZHENG RS, ZHANG SW, ZENG HM, et al. Cancer incidence and mortality in China, 2016[J]. J Natl Cancer Cent, 2022, 2( 1): 1- 9. DOI: 10.1016/j.jncc.2022.02.002.
    [2] KANDA M, MATTHAEI H, WU J, et al. Presence of somatic mutations in most early-stage pancreatic intraepithelial neoplasia[J]. Gastroenterology, 2012, 142( 4): 730- 733. e 9. DOI: 10.1053/j.gastro.2011.12.042.
    [3] MARIN AM, BATISTA M, de AZEVEDO ALK, et al. Screening of exosome-derived proteins and their potential as biomarkers in diagnostic and prognostic for pancreatic cancer[J]. Int J Mol Sci, 2023, 24( 16): 12604. DOI: 10.3390/ijms241612604.
    [4] HANAHAN D, WEINBERG RA. Hallmarks of cancer: The next generation[J]. Cell, 2011, 144( 5): 646- 674. DOI: 10.1016/j.cell.2011.02.013.
    [5] HUANG J, GAO G, GE Y, LIU JZ, et al. Development of a serum-based microRNA signature for early detection of pancreatic cancer: a multicenter cohort study[J]. Dig Dis Sci, 2024.[Forthcoming]
    [6] LI H, CHIANG CL, KWAK KJ, et al. Extracellular vesicular analysis of glypican 1 mRNA and protein for pancreatic cancer diagnosis and prognosis[J]. Adv Sci(Weinh), 2024. DOI: 10.1002/advs.202306373.[ Online ahead of Print]
    [7] KAMAL MA, SIDDIQUI I, BELGIOVINE C, et al. Oncogenic KRAS-induced protein signature in the tumor secretome identifies laminin-C2 and pentraxin-3 as useful biomarkers for the early diagnosis of pancreatic cancer[J]. Cancers(Basel), 2022, 14( 11): 2653. DOI: 10.3390/cancers14112653.
    [8] CAVE DD, BUONAIUTO S, SAINZ B Jr, et al. LAMC2 marks a tumor-initiating cell population with an aggressive signature in pancreatic cancer[J]. J Exp Clin Cancer Res, 2022, 41( 1): 315. DOI: 10.1186/s13046-022-02516-w.
    [9] CHEN XB, LIAO XM, ZHENG BL, et al. Differential plasma proteins identified via iTRAQ-based analysis serve as diagnostic markers of pancreatic ductal adenocarcinoma[J]. Dis Markers, 2023, 2023: 5145152. DOI: 10.1155/2023/5145152.
    [10] LUO XL, LIU JJ, WANG HZ, et al. Metabolomics identified new biomarkers for the precise diagnosis of pancreatic cancer and associated tissue metastasis[J]. Pharmacol Res, 2020, 156: 104805. DOI: 10.1016/j.phrs.2020.104805.
    [11] ZHAO R, REN S, LI CY, et al. Biomarkers for pancreatic cancer based on tissue and serum metabolomics analysis in a multicenter study[J]. Cancer Med, 2023, 12( 4): 5158- 5171. DOI: 10.1002/cam4.5296.
    [12] CAO YY, ZHAO R, GUO K, et al. Potential metabolite biomarkers for early detection of stage-I pancreatic ductal adenocarcinoma[J]. Front Oncol, 2022, 11: 744667. DOI: 10.3389/fonc.2021.744667.
    [13] SAHNI S, PANDYA AR, HADDEN WJ, et al. A unique urinary metabolomic signature for the detection of pancreatic ductal adenocarcinoma[J]. Int J Cancer, 2021, 148( 6): 1508- 1518. DOI: 10.1002/ijc.33368.
    [14] SKUBISZ K, DĄBKOWSKI K, SAMBOROWSKA E, et al. Serum metabolite biomarkers for pancreatic tumors: Neuroendocrine and pancreatic ductal adenocarcinomas-a preliminary study[J]. Cancers(Basel), 2023, 15( 12): 3242. DOI: 10.3390/cancers15123242.
    [15] EISSA MAL, LERNER L, ABDELFATAH E, et al. Promoter methylation of ADAMTS1 and BNC1 as potential biomarkers for early detection of pancreatic cancer in blood[J]. Clin Epigenetics, 2019, 11( 1): 59. DOI: 10.1186/s13148-019-0650-0.
    [16] LI SY, WANG L, ZHAO Q, et al. Genome-wide analysis of cell-free DNA methylation profiling for the early diagnosis of pancreatic cancer[J]. Front Genet, 2020, 11: 596078. DOI: 10.3389/fgene.2020.596078.
    [17] SCHOTT S, YANG RX, STÖCKER S, et al. HYAL2 methylation in peripheral blood as a potential marker for the detection of pancreatic cancer: A case control study[J]. Oncotarget, 2017, 8( 40): 67614- 67625. DOI: 10.18632/oncotarget.18757.
    [18] WU YN, SEUFERT I, AL-SHAHERI FN, et al. DNA-methylation signature accurately differentiates pancreatic cancer from chronic pancreatitis in tissue and plasma[J]. Gut, 2023, 72( 12): 2344- 2353. DOI: 10.1136/gutjnl-2023-330155.
    [19] MAKLER A, ASGHAR W. Exosomal miRNA biomarker panel for pancreatic ductal adenocarcinoma detection in patient plasma: A pilot study[J]. Int J Mol Sci, 2023, 24( 6): 5081. DOI: 10.3390/ijms24065081.
    [20] XIAO D, DONG ZJ, ZHEN LQ, et al. Combined exosomal GPC1, CD82, and serum CA19-9 as multiplex targets: A specific, sensitive, and reproducible detection panel for the diagnosis of pancreatic cancer[J]. Mol Cancer Res, 2020, 18( 2): 300- 310. DOI: 10.1158/1541-7786.MCR-19-0588.
  • 加载中
表(3)
计量
  • 文章访问数:  852
  • HTML全文浏览量:  907
  • PDF下载量:  392
  • 被引次数: 0
出版历程
  • 收稿日期:  2024-01-12
  • 录用日期:  2024-02-01
  • 出版日期:  2024-03-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回