The Use of Molecular Technology in the Differentiation of Pancreatic Cancer and Chronic Pancreatitis

Abstract

Conclusion. It is concluded that currently there are limitations in the use of some of the proposed tests, whereas in the future, further progress in our understanding of the molecular biology of pancreatic disease and the development and application of existing techniques should have a greater impact on clinical practice. Background. Fifteen to 20% of patients with pancreatic cancer present with a resectable mass in the head of the pancreas, but there is a subgroup of patients for whom it is difficult to reach the correct diagnosis. Method. This article addresses how molecular technology can be used to aid in the diagnosis of this group of patients. The clinical and scientific literature is reviewed by accessing papers through the Medline database. Results. This article reviews the limitations of conventional imaging techniques and the limitations of fine needle aspiration cytology and cytological examination of pancreatic duct secretions. The molecular biology of both pancreatic cancer and chronic pancreatitis is then reviewed with emphasis on the common molecular defects seen in these diseases. The current use of molecular techniques in the examination of cytological and histological specimens, stool, blood, and pancreatic duct secretions and how this helps discriminate between benign and malignant lesions of the pancreas is addressed. Finally, the use of novel serum screening tests in groups at high risk of pancreatic cancer is discussed.