高危人群胰腺癌监测:CA199和内镜超声应用的多中心研究

2008-09-06 11:11 来源: 作者: 网友评论 0 条 浏览次数 105
使用内镜超声结合监测CA19-9变化的方法更可能监测最可能得到治疗的胰腺癌早期。由于国内尚缺乏可接受的胰腺癌筛选工具,该发现很重要。目前,当患者出现症状检查时多处于疾病的进展期。
A new screening method using CA19-9, a tumor marker that is most often used to monitor disease progress as well as predict survival rates, with endoscopic ultrasound is more likely to detect pancreatic cancer in its early stages when it is most treatable. 使用内镜超声结合监测CA19-9变化的方法更可能监测最可能得到治疗的胰腺癌早期。The finding is significant because a nationally-accepted screening tool for pancreatic cancer does not exist. Currently, most cases are detected when patients present with symptoms at advanced stages of the disease.由于国内尚缺乏可接受的胰腺癌筛选工具,该发现很重要。目前,当患者出现症状检查时多处于疾病的进展期。

"Pancreatic cancer is more detectable through this process than traditional screening protocols," said Richard Zubarik, MD, associate professor of medicine and chief of endoscopy at Fletcher Allen Health Care, Burlington, Vermont. 佛蒙特州柏林顿Fletcher Allen 医学副教授和内镜主任Richard Zubarik 医学博士表示“与传统的诊断模式相比,该程序让胰腺癌更容易得到检测。”"Our research finds that the CA 19-9 screening method can detect pancreatic cancer at an earlier stage in high-risk populations." “我们的研究发现CA19-9检测能在高风险人群中早期探测到胰腺癌”These include people with a first degree relative with pancreatic cancer, people who smoke, people with diabetes, and people aged 50 or older. 这些包括一级亲属患者胰腺癌的人群、吸烟者、糖尿病者和大于50岁以上的人群。Dr. Zubarik added that more than 90 percent of the people who develop pancreatic cancer are over the age of 50. Zubarik医生补充说大于90%的胰腺癌患者高于50岁。

For the study, investigators performed an endoscopic ultrasound if the CA 19-9 level was =37 (reference range 0 - 37 U/ml). Fine needle aspiration was performed during this process if a lesion was identified. Patients with pancreatic cancer detected through this protocol were compared to patients who were not screened through this method. 在该研究中,当CA19-9高于37时,研究者进行超声检查。当发现病灶时进行穿刺活检。通过该程序得到确诊的患者与未经过该方法的患者进行比较。

Medicare reimbursement rates were used to determine cost data, and investigators concluded that the new screening method is expected to reduce medical costs. The cost to detect pancreatic cancer was just over $14,000, and the cost to detect pancreatic neoplastic tumors (abnormal cell growth) using this method is approximately $11,000. 没有使用医疗赔偿率来评价花费数目,调查者总结说新的筛查方法有望减少医疗花费。检测胰腺癌的费用约$14,000,检测胰腺新生物(异常细胞增殖)的费用大约$11,000。

The new screening method does have limitations. With very small tumors, its sensitivity declines. 新的监测方法也有局限性。对于小的病灶,它的敏感性降低。Still, Stage 1 cancers are significantly more likely to be detected through this protocol than through more traditional methods. 然而,比起传统方法,I期患者更容易得到发现。"Right now, this appears to be the best test we have. We hope this will help us develop even better screening tools in the future," Dr. Zubarik said. Zubarik 医生表示“现在,该方法似乎是目前最好的方法。我们希望这有助于帮助我们将来发现更好的筛查方法。”

编译:
使用内镜超声结合监测CA19-9变化的方法更可能监测最可能得到治疗的胰腺癌早期。由于国内尚缺乏可接受的胰腺癌筛选工具,该发现很重要。目前,当患者出现症状检查时多处于疾病的进展期。

佛蒙特州柏林顿Fletcher Allen 医学副教授和内镜主任Richard Zubarik 医学博士表示“与传统的诊断模式相比,该程序让胰腺癌更容易得到检测。” “我们的研究发现CA19-9检测能在高风险人群中早期探测到胰腺癌” 这些包括一级亲属患者胰腺癌的人群、吸烟者、糖尿病者和大于50岁以上的人群。Zubarik医生补充说大于90%的胰腺癌患者高于50岁。

在该研究中,当CA19-9高于37时,研究者进行超声检查。当发现病灶时进行穿刺活检。通过该程序得到确诊的患者与未经过该方法的患者进行比较。

没有使用医疗赔偿率来评价花费数目,调查者总结说新的筛查方法有望减少医疗花费。检测胰腺癌的费用约$14,000,检测胰腺新生物(异常细胞增殖)的费用大约$11,000。

新的监测方法也有局限性。对于小的病灶,它的敏感性降低。然而,比起传统方法,I期患者更容易得到发现。Zubarik 医生表示“现在,该方法似乎是目前最好的方法。我们希望这有助于帮助我们将来发现更好的筛查方法。”

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