An Overview of Pancreatic Cancer Diagnosis and Treatment in China: Current Landscape and Future Prospects.
Main Article Content
Keywords
Pancreatic Cancer, Tumor Markers, Immunotherapy, Diagnosis, Treatment
Abstract
This comprehensive literature review is to summarize the most recent findings regarding the causes, diagnosis, and treatments of pancreatic cancer and to encourage additional investigation into this under-researched malignant tumor. Pancreatic cancer is a significant public health issue in China, with annual mortality rates almost equal to incidence rates. The disease is more prevalent in rural areas and has a poor prognosis. The data was collected from the following databases: PubMed, Crossref, Science Direct, Scopus, and Google Scholar we reviewed published articles from 2018 to 2023 on the annual incidence of pancreatic cancer in China is 5.1%, with only 5-7% of patients completely cured. The prognosis is extremely poor, with a 1-year survival rate of 8% and a 5-year survival rate of 3%. Pancreatic cancer has no specific clinical manifestations or tumor markers, and its characteristics are not typical of high-risk factors including smoking, alcohol, chronic pancreatitis, abnormal microorganism metabolism, blood type, and glucose and lipid levels. For increased detection and survival rates, pancreatic cancer must be diagnosed as early as possible. However, the low specificity of tumor markers calls for more study. Future treatment strategies could include immunotherapy and a microbiology-free system, and it's anticipated that they'll offer intriguing clinical applications for extending patients' lives with pancreatic cancer. Finally, we suggest measures to improve the health outcomes of pancreatic cancer patients in China.
References
[2] Murage P, Bachmann MO, Crawford SM, McPhail S, Jones A. Geographical access to GPs and modes of cancer diagnosis in England: a cross-sectional study. Fam Pract.https://doi.org/10.1093/fampra/cmy077
[3] Y. Zhang, J. Yang, X. Cui, Y. Chen, V.F. Zhu, J.P. Hagan, H. Wang, X. Yu, S.E. Hodges, J. Fang, P.J. Chiao, C.D. Logsdon, W.E. Fisher, F.C. Brunicardi, C. Chen, Q. Yao, M.E. Fernandez-Zapico, M. Li, A novel epigenetic CREB-miR-373 axis mediates ZIP4-induced pancreatic cancer growth, EMBO Mol. Med. 5 (2013) 1322–1334.
[4] McMenamin UC, McCain S, Kunzmann AT. Do smoking and alcohol behaviours influence GI cancer survival? Best Pract Res Clin Gastroenterol. 2017;31(5):569-577.https://doi.org/10.1016/j.bpg.2017.09.015
[5] Jang YC, Leung CY, Huang HL. Association of Menopausal Hormone Therapy with Risk of Pancreatic Cancer: A Systematic Review and Meta-analysis of Cohort Studies. Cancer Epidemiol Biomarkers Prev. 2023 Jan 9;32(1):114-122. https://doi.org/10.1158/1055-9965.
[6] Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin 2010; 60:277–300. https://doi.org/10.3322/caac.20073
[7] Li BQ, Wang L, Li J, Zhou L, Zhang TP, Guo JC, Zhao YP. Surgeons' knowledge regarding the diagnosis and management of pancreatic cancer in China: a cross-sectional study. BMC Health Serv Res. 2017 Jun 9;17(1):395. https://doi.org/10.1186/s12913-017-2345-6
[8] Wolfgang CL, Herman JM, Laheru DA, Klein AP, Erdek MA, Fishman EK, Hruban RH. Recent progress in pancreatic cancer. CA Cancer J Clin 2013; 63:318–348. https://doi.org/10.3322/caac.21190
[9] Chu D, Kohlmann W, Adler DG. Identification and screening of individuals at increased risk for pancreatic cancer with emphasis on known environmental and genetic factors and hereditary syndromes. JOP 2010; 11: 203-212.
[10] Ge L, Pan B, Song F, et al. Comparing the diagnostic accuracy of five common tumor biomarkers and CA19-9 for pancreatic cancer: a protocol for a network meta-analysis of diagnostic test accuracy. BMJ Open. 2017;7(12):e018175. https://doi.org/10.1136/bmjopen-2017-018175
[11] Goonetilleke KS, Siriwardena AK. Systematic review of carbohydrate antigen (CA 19-9) as a biochemical marker in the diagnosis of pancreatic cancer. Eur J Surg Oncol. 2007;33(3):266-270. https://doi.org/10.1016/j.ejso.2006.10.004
[12] Hufnagl C, Leisch M, Weiss L, et al. Evaluation of circulating cell-free DNA as a molecular monitoring tool in patients with metastatic cancer. Oncol Lett. 2020;19(2):1551–1558. https://doi.org/10.3892/ol.2019.11192
[13] He P, Yang JW, Yang VW, Bialkowska AB. Kruppel-like factor 5, increased in pancreatic ductal adenocarcinoma, promotes proliferation, acinar-to-Ductal metaplasia, pancreatic intraepithelial neoplasia, and tumor growth in mice. Gastroenterology (2018) 154(5):1494–508.e13. doi: 10.1053/j.gastro.2017.12.005
[14] Ghaneh P, Hanson R, Titman A, et al. PET-PANC: multicenter prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer. Health Technol Assess. 2018;22(7):1–114. https://doi.org/10.3310/hta22070
[15] Yeo SJ, Cho CM, Jung MK, Seo AN, Bae HI. Comparison of the diagnostic performances of same-session endoscopic ultrasound- and endoscopic retrograde cholangiopancreatography-guided tissue sampling for suspected biliary strictures at different primary tumor sites. Korean J Gastroenterol. 2019;73(4):213–218. https://doi.org/10.4166/kjg.2019.73.4.213
[16]Kamisawa T, Wood LD, Itoi T, Takaori K. Pancreatic cancer. Lancet 2016;388(10039):73–85. https://doi.org/10.1016/s0140-6736(16)00141-0
[17] Mikata R, Ishihara T, Tada M, et al. Clinical usefulness of repeated pancreatic juice cytology via endoscopic naso-pancreatic drainage tube in patients with pancreatic cancer. J Gastroenterol. 2013;48(7):866–873. doi:10.1007/s00535-012-0684-y
[18] Kamisawa T, Wood LD, Itoi T, Takaori K. Pancreatic cancer. Lancet 2016;388(10039):73–85. doi:10.1016/s0140-6736(16)00141-0.
[19] Strobel O, Neoptolemos J, Jager D, Buchler MW. Optimizing the outcomes of pancreatic cancer surgery.
Nat Rev Clin Oncol. 2019;16(1):11–26. doi:10.1038/s41571-018-0112 -1
[20] Springfeld C, Jäger D, Büchler MW, Strobel O, Hackert T, Palmer DH, Neoptolemos JP. Chemotherapy for pancreatic cancer. Presse Med. 2019;48(3 Pt 2): e159–e174.doi: 10.1016/j.lpm.2019.02.025
[21] Chin V, Nagrial A, Sjoquist K, O'Connor CA, Chantrill L, Biankin AV, Scholten RJ, Yip D. Chemotherapy and radiotherapy for advanced pancreatic cancer. Cochrane Database Syst Rev 2018;3(3):CD011044. doi: 10.1002/14651858.CD011044.pub2
[22] Kimura H, Yamamoto H, Harada T, Fumoto K, Osugi Y, Sada R, et al. CKAP4, a DKK1 Receptor, Is a Biomarker in Exosomes Derived from Pancreatic Cancer and a Molecular Target for Therapy. Clin Cancer Res. 2019;25(6):1936-1947. doi: 10.1158/1078-0432.CCR-18-2124
[23] Benci JL, Johnson LR, Choa R, Xu Y, Qiu J, Zhou Z, et al. Opposing functions of interferon coordinate adaptive and innate immune responses to cancer immune checkpoint blockade. Cell. 2019;178(4):933–948. e914. https://doi.org/10.1016/j.cell.2019.07.019
[24] Schulz MD, Atay C, Heringer J, Romrig FK, Schwitalla S, Aydin B, et al. High-fat-diet-mediated dysbiosis promotes intestinal carcinogenesis independently of obesity. Nature 2014;514(7523):508–512. https://doi.org/10.1038/nature13398
[25] Oncologist Branch of Chinese Medical Association; Expert Committee on Pancreatic Diseases of China Association for the Promotion of International Health Care Exchange; Abdominal Cancer Expert Committee of China Medical Education Association. [Expert consensus on the MDT model of pancreatic cancer in China (2020 Edition)]. Zhonghua Zhong Liu Za Zhi. 2020 Jul 23;42(7):531-536. Chinese. doi: 10.3760/cma.j.cn112152-20200310-00192.
[26] Kirkegard J, Aahlin EK, Al-Saiddi M, Bratlie SO, Coolsen M, de Haas RJ, et al. Multicentre study of multidisciplinary team assessment of pancreatic cancer resectability and treatment allocation. Br J Surg (2019) 106(6):756–64. doi: 10.1002/bjs.11093
[27] Dulai R, Shunmugam SR, Veasey RA, Patel NR, Sugihara C, Furniss S. An economic evaluation of an advanced video conferencing system for cardiac multidisciplinary team meetings. Int J Clin Pract (2020) 74(9):e13562. doi: 10.1111/ijcp.13562
[28] Kamisawa T, Wood LD, Itoi T, Takaori K. Pancreatic cancer. Lancet. 2016;388(10039):73–85. doi:10.1016/s0140-6736(16)00141-0.
[29] McGuigan A, Kelly P, Turkington RC, Jones C, Coleman HG, McCain RS. Pancreatic cancer: a review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol. 2018;24(43):4846–4861. https://doi.org/10.3748/wjg.v24.i43.4846
[30] Wu WR, He XK, Yang LY, Wang Q, Bian XY, Ye JZ, et al. Rising trends in pancreatic cancer incidence and mortality in 2000-2014. Clin Epidemiol 2018;10:789 – 97.
[31] Salman B, Zhou DE, Jaffee EM, Edil BH, Zheng L. Vaccine therapy for pancreatic cancer. Oncoimmunology 2013;2(12):e26662.
[32] Iodice S, Gandini S, Maisonneuve P, Lowenfels AB. Tobacco and the risk of pancreatic cancer: a review and meta-analysis. Langenbeck's Arch Surg 2008;393(4):535 − 45
[33] Cai J, Chen HD, Lu M, Zhang YH, Lu B, You L, et al. Trend analysis on morbidity and mortality of pancreatic cancer in China, 2005-2015. Chin J Epidemiol 2021;42(5):794 − 800
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