Advances in the early detection, diagnosis, and staging of pancreatic cancer

Pancreatic cancer is an aggressive disease with a dismal prognosis, It has long been regarded as one of the most difficult cancers to accurately diagnose and stage preoperatively, The purpose of this review is to provide an update of the state-of-the-art for early detection, diagnosis, and staging of pancreatic cancer, These methods include spiral CT scans, magnetic resonance imaging, positron emission tomography (PET) imaging, laparoscopy, endoscopic ultrasound, CA 19-9 serology, fine needle aspiration cytology, ERCP brush cytology, and screening for p53 and ras oncogenes, These advanced techniques should help us to detect pancreatic cancers in high-risk populations at a curative stage and to decrease pancreatico-duodenectomies for benign disease which could otherwise be treated with less morbid procedures, In addition, these tests will help reliably diagnose pancreatic cancer preoperatively, (C) 1998 Elsevier Science Ltd.