胰腺癌可切除性评估标准:形态学还是生物学?
The criteria of resectability for pancreatic ductal adenocarcinoma:tumor anatomy or tumor biology?
摘要长期以来,基于影像学表现建立的胰腺癌可切除性评估标准是指导临床实践的主要甚或是唯一标准,影像学即形态学标准对于规范手术指征、约束医疗行为有非常积极的作用。在目前系统治疗的时代背景下,形态学标准的局限性日益凸显。目前可用于胰腺癌可切除性评估的生物学标准有限,但综合利用CA19-9、PET-CT、新辅助治疗、基因检测等仍可为胰腺癌可切除性评估提供参考。针对胰腺癌的可切除性评估,目前仍应坚持以形态学表现为基础,以生物学标准为导向,以改善患者预后为目标的基本原则。
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abstractsAnatomical resectability criteria based on radiologic findings for pancreatic ductal adenocarcinoma has been the main or even the only criterion in practice for a long time. The anatomical criteria has played a very positive role in standardizing surgical indication and restricting medical behavior. However,in the current era of systematic treatment,the limitations of anatomical criteria are becoming increasingly prominent. Although the biological criteria which can be used to evaluate the resectability of pancreatic cancer is still very limited,the comprehensive benefit of CA19-9,PET-CT,neoadjuvant therapy,gene detection and so on can still provide a reference for the evaluation of the resectability of pancreatic cancer. At present,the evaluation of resectability of pancreatic cancer should still adhere to the basic principle of taking anatomical criteria as the basis,biological criteria as the guide,and improving the prognosis of patients as the goal.
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