摘要
目的梳理胰腺癌诊断筛查方式的历史沿革,探究在中国人口基数大、经济处于发展中的背景下,如何实现胰腺癌的"早诊早治"。方法采用系统回顾的方法进行分析。计算机检索CNKI、VIP、WanFang Data、Web of Science、PubMed和EMbase数据库,同时由两名研究员独立检索百度搜索引擎,检索时限均从建库至2018年2月28日,搜集胰腺癌筛查方法及效果评价的相关报道,进行定性描述。结果共117篇文献纳入研究。国内对胰腺癌筛查方式的探索经历了萌芽、启蒙和成长三个阶段。现有筛查方式有临床表现、影像学方法、血清肿瘤标记物和分子生物学基因诊断四种,各有利弊。单一手段无法实现较高特异性和灵敏度,联合检测成为必然趋势。考虑到应用过程中的效益问题,在高危人群中进行筛查可以有效缩小人群范围,实现精准筛查。结论我国针对胰腺癌筛查方面的研究较国外有较大差距。筛查方法呈现多样性,联合检测是必然趋势。在高危人群中进行胰腺癌筛查将成为技术瓶颈下的突破口。
Objective To sort out the historical evolution of diagnostic screening methods for pancreatic cancer,and to explore how to achieve early diagnosis and treatment of pancreatic cancer in the context of China’s large population base and economic development.Methods A systematic review was performed.Databases including CNKI,VIP,WanFang Data,Web of Science,PubMed and EMbase were searched.Two researchers independently used Baidu search engine to collect relevant reports on screening methods and effect evaluation of pancreatic cancer published before February 28,2018,and a qualitative description was made.Results A total of 117 articles were included.The exploration of screening methods for pancreatic cancer in China has experienced 3 stages:germination,enlightenment and growth.Current screening methods include clinical manifestations,imaging screening methods,serum tumor markers and molecular biology gene diagnosis,each of which had its advantages and disadvantages.Using a single method could not achieve higher specificity and sensitivity,and joint detection had become an inevitable trend.Considering the benefit of practical application,screening among high-risk groups could effectively reduce the population size and achieve accurate screening.Conclusions There was a big gap between domestic and foreign research in screening for pancreatic cancer.Screening methods are diverse,and joint detection is an inevitable trend.Screening for pancreatic cancer in high-risk population will become a breakthrough under the technical bottleneck.
作者
徐康捷
江华
石建伟
黄蛟灵
刘娜娜
巩昕
薄小杰
刘茜
陈宁
杨燕
王朝昕
XU Kangjie;JIANG Hua;SHI Jianwei;HUANG Jiaoling;LIU Nana;GONG Xin;BO Xiaojie;LIU Qian;CHEN Ning;YANG Yan;WANG Chaoxin(School of Economics&Management,Tongji University,Shanghai 200092,P.R.China;General Practice Medicine,Dongfang Hospital of Tongji University,Shanghai 200092,P.R.China;School of Public Health,Shanghai Jiaotong University School of Medicine,Shanghai 200092,P.R.China;Yangpu Hospital,Tongji University School of Medicine,Shanghai 200092,P.R.China;Tongji University School of Medicine,Shanghai 200092,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2020年第2期221-226,共6页
Chinese Journal of Evidence-based Medicine
基金
国家自然科学基金项目(编号:71774116)
上海市科学技术委员会软课题重点项目(编号:17692105200)
上海市卫生和计划生育委员会面上项目(编号:201740202)
中央高校专项基金学科交叉面上项目(滚动类)(编号:1500219131)
上海市卫生计生系统重要薄弱学科建设项目(编号:2015ZB0602)
关键词
胰腺癌
筛查方法
系统回顾
联合检测
高危人群
Pancreatic cancer
Screening method
Systematic review
Joint detection
High-risk group
