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1、JOP.JPancreas(Online)2010Nov9;11(6):536-544.EDITORIALMolecularandClinicalMarkersofPancreasCancer12JamesLBuxbaum,MohamadAEloubeidi1DivisionsofGastroenterologyandHepatology,UniversityofSouthernCalifornia.2LosAngeles,CA,USA.UniversityofAlabamainBirmingham.Birmingham,AL,USA
2、SummaryPancreascancerhastheworstprognosisofanysolidtumorbutispotentiallytreatableifitisdiagnosedatanearlystage.Thusthereiscriticalinterestindelineatingclinicalandmolecularmarkersofincipientdisease.Thecurrentlyavailablebiomarker,CA19-9,hasaninadequatesensitivityandspecif
3、icitytoachievethisobjective.Diabetesmellitus,tobaccouse,andchronicpancreatitisareassociatedwithpancreascancer.However,screeningiscurrentlyonlyrecommendedinthosewithhereditarypancreatitisandgeneticsyndromeswhichpredisposetocancer.Ongoingworktoidentifyearlymarkersofpancre
4、ascancerconsistsofhighthroughputdiscoverymethodsincludinggenearraysandproteomicsaswellashypothesisdrivenmethods.WhileseveralpromisingcandidateshavebeenidentifiednonehasyetbeenconvincinglyproventobebetterthanCA19-9.Newmethodsincludingendoscopicultrasoundareimprovingdetec
5、tionofpancreascancerandarebeingusedtoacquiretissueforbiomarkerdiscovery.Pancreascancerhasthedarkestprognosisofanypoorscreeningtest.AttheSamsungMedicalCenteringastrointestinalcancerwiththemortalityapproachingSouthKorea70,940asymptomaticpatientsweretheincidence[1].Whileth
6、eoverallfiveyearsurvivalscreenedusingCA19-9.However,among1,063withislessthan4%,thoserecognizedearly,withtumorelevatedlevelsonly4hadpancreascancerandonly2involvingonlythepancreashavea25-30%five-yearhadresectabledisease[6].Nonetheless,CA19-9issurvivalaftersurgery[2].Given
7、thelimitedtreatmentwidelyusedtoevaluatepatientswithsuspectedoptionstherehasbeenconsiderablefocusonclinicalpancreascancerandthoseundergoingtreatment.andmolecularharbingersofearlydisease.Mostcasesofpancreascancerarediagnosedbythediscoveryofamassbycomputedtomography(CT)orC
8、urrentlyAvailableToolstoEvaluateforPancreasmagneticresonanceimaging.EndoscopicultrasoundCancer(EUS),inwhichahi
