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Resumen
El cáncer de páncreas (CP) es una entidad de difícil manejo, sobre todo por su mal pronóstico. Crece la importancia del cribado en pacientes de riesgo, basado sobre todo en la ultrasonografía endoscópica (USE). Se continúa identificando factores de riesgo, como la sacarosa, el tabaco o las lesiones quísticas y otros protectores, como la vitamina E. Parece también evidenciarse una estrecha relación entre CP y diabetes mellitus, con un subgrupo de pacientes en los que la diabetes puede anticiparse hasta en 2 años al diagnostico de la enfermedad. Desde el punto de vista diagnóstico se confirma la USE como la prueba en mayor desarrollo, asociada a la elastografía y la punción guiada por USE, que obtiene y procesa mejor las muestras, y permite realizar con frecuencia análisis inmunohistoquímicos, que mejoran la rentabilidad diagnóstica. Para el tratamiento destacan los ultrasonidos de alta frecuencia o la crioterapia. Sobre los tumores quísticos de páncreas, destaca su incidencia creciente. La USE se ha situado como la técnica de elección en estos tumores. La mayoría de los estudios se encaminan a la optimización del manejo de estas lesiones (sobre todo los tumores mucinosos papilares intraductales), tratando de determinar aquellos en los que se puede realizar un manejo conservador.
Palabras clave:
Cáncer de páncreas
Tumor quístico de páncreas
Tumores pancreáticos
Ultrasonografía endoscópica
Abstract
Cancer of the pancreas is a disease that is difficult to manage, particularly because of its poor prognosis. The importance of screening in at-risk patients is growing, especially screening based on endoscopic ultrasound (EUS). Risk factors continue to be identified, such as saccharose, smoking, and cystic lesions, while protective factors have also come to light, such as vitamin E. There also seems to be a close relation between pancreatic cancer and diabetes mellitus, with a subgroup of patients at greater risk of developing pancreatic cancer in the two years after diagnosis of diabetes. From the diagnostic point of view, EUS is the most widely developed test, in association with elastography and EUSguided biopsy. This test is the most effective in obtaining and processing the samples and often allows immunohistochemical analyses, which improve diagnostic performance. Notable among treatment options are high-frequency ultrasound and cryotherapy. The incidence of cystic tumors of the pancreas is increasing. In these tumors, EUS has become the technique of choice. Most studies aim to optimize the management of these lesions (especially intraductal papillary mucinous tumors) and attempt to determine those suitable for conservative management.
Keywords:
Cancer of the pancreas
Cystic tumor of the pancreas
Pancreatic tumors
Endoscopic ultrasound
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