胰腺炎,包括急性和慢性形式,胰腺癌对胰腺的外分泌组织构成重大挑战。急性胰腺炎发作后的复发率和并发症可导致长期风险,包括糖尿病。慢性胰腺炎可以在大约15%的病例中发展,无论最初发作的严重程度如何。酒精性胰腺炎,特发性原因,吸烟,遗传性胰腺炎有助于进展为慢性胰腺炎。慢性胰腺炎与胰腺癌风险增加有关,发病年龄较大,吸烟被确定为危险因素。本范围审查旨在综合最近的出版物(2017-2022)关于胰腺炎和胰腺癌之间的诊断区分,同时确定该领域的知识差距。该综述重点关注胰腺炎和胰腺癌患者的生物标志物和成像技术。有希望的生物标志物如粪便弹性蛋白酶-1和特异性趋化因子提供非侵入性的方法来评估胰腺功能不全和检测慢性胰腺炎的早期生物标志物。成像技术,包括计算机断层扫描(CT),磁共振成像(MRI),超声内镜(EUS),和正电子发射断层扫描(PET),有助于区分慢性胰腺炎和胰腺癌。然而,准确区分这两个条件仍然是一个挑战,特别是当胰头有肿块时。尽管在理解胰腺炎和胰腺癌之间的关联方面取得了进展,但仍存在一些知识差距。包括组织病理学分级系统之间的相关性,非侵入性成像技术,和慢性胰腺炎的生物标志物来确定进展为胰腺癌的风险,以及区分这两个条件。需要进一步的研究来增强我们对这些方面的认识,最终可以改善胰腺炎和胰腺癌的诊断和治疗。
Pancreatitis, encompassing acute and chronic forms, and pancreatic cancer pose significant challenges to the exocrine tissue of the pancreas. Recurrence rates and complications following acute pancreatitis episodes can lead to long-term risks, including diabetes mellitus. Chronic pancreatitis can develop in approximately 15% of cases, regardless of the initial episode\'s severity. Alcohol-induced pancreatitis, idiopathic causes, cigarette smoking, and hereditary pancreatitis contribute to the progression to chronic pancreatitis. Chronic pancreatitis is associated with an increased risk of pancreatic cancer, with older age at onset and smoking identified as risk factors. This scoping
review aims to synthesise recent publications (2017-2022) on the diagnostic differentiation between pancreatitis and pancreatic cancer while identifying knowledge gaps in the field. The
review focuses on biomarkers and imaging techniques in individuals with pancreatitis and pancreatic cancer. Promising biomarkers such as faecal elastase-1 and specific chemokines offer non-invasive ways to assess pancreatic insufficiency and detect early biomarkers for chronic pancreatitis. Imaging techniques, including computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasound (EUS), and positron emission tomography (PET), aid in differentiating between chronic pancreatitis and pancreatic cancer. However, accurately distinguishing between the two conditions remains a challenge, particularly when a mass is present in the head of the pancreas. Several knowledge gaps persist despite advancements in understanding the association between pancreatitis and pancreatic cancer, including the correlation between histopathological grading systems, non-invasive imaging techniques, and biomarkers in chronic pancreatitis to determine the risk of progression to pancreatic cancer, as well as differentiating between the two conditions. Further research is necessary to enhance our understanding of these aspects, which can ultimately improve the diagnosis and management of pancreatitis and pancreatic cancer.