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Wiener klinisches Magazin

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01.06.2016 | Onkologie

Pankreaskarzinom

Risikofaktoren, Hochrisikodefinition und mögliche Screeningmaßnahmen

verfasst von: Dr. Florian Obermair, Dr. Ulrich Popper, Dr. Franz Romeder, OA Priv.-Doz. Holger Rumpold

Erschienen in: Wiener klinisches Magazin | Ausgabe 3/2016

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Zusammenfassung

Das Pankreaskarzinom (PK) weist von allen Karzinomen des Gastrointestinaltraktes die schlechteste Prognose auf. In den letzten Jahren wurden zunehmend Faktoren identifiziert, die mit einem deutlich erhöhten PK-Risiko einhergehen. Dazu werden sowohl genetische als auch nicht genetische Risikofaktoren gezählt. Erstere umfassen einerseits gut etablierte Tumorsyndrome wie das erbliche Brust- und Eierstockkrebssyndrom (BRCA1, BRCA2, PALB2) oder das Lynch-Syndrom (MLH1, MSH2, MSH6, PMS2) aber auch seltenere Tumorsyndrome wie das Peutz-Jeghers-Syndrom (STK11) oder das familiäre multiple Melanom-Syndrom (CDKN2a). Zudem werden die hereditäre Pankreatitis (PRSS1, SPINK, CFTR, PRSS2) und die Nicht-0-Blutgruppen im ABO-System zu den erblichen Risikofaktoren gezählt. Unter den nicht genetischen Risikofaktoren finden sich zum einen lebensstilassoziierte Faktoren wie Rauchen, Adipositas oder Alkoholabusus und zum anderen internistische Erkrankungen wie Hepatitis B/C, Helicobacter-pylori-Infektion, chronische Pankreatitis oder Diabetes mellitus.

Diese Risikofaktoren sollen bestimmte Hochrisikokohorten definieren, die von Screeningmaßnahmen profitieren könnten. Trotz zahlreicher PK-Screening-Studien mit unterschiedlichen Modalitäten wie beispielsweise endoskopischer Ultraschall (EUS) oder Magnetresonanz-Cholangiopankreatikographie (MRCP) konnte bisher in keiner dieser Studien ein Überlebensvorteil gezeigt werden. Aus diesem Grund gibt es bisher keinen Konsens über die Art, den Beginn und die Intervalle eines PK-Screenings, weshalb ein solches derzeit nur im Rahmen von klinischen Studien angeboten werden soll.

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Titel: Pankreaskarzinom
Risikofaktoren, Hochrisikodefinition und mögliche Screeningmaßnahmen
verfasst von: Dr. Florian Obermair
Dr. Ulrich Popper
Dr. Franz Romeder
OA Priv.-Doz. Holger Rumpold
Publikationsdatum: 01.06.2016
Verlag: Springer Vienna
Erschienen in: Wiener klinisches Magazin / Ausgabe 3/2016
Print ISSN: 1869-1757
Elektronische ISSN: 1613-7817
DOI: https://doi.org/10.1007/s00740-016-0107-4

Springer Medizin Österreich

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