Stool testing for the early detection of pancreatic cancer: rationale and current evidence

摘要

The development of effective tools for the early detection of pancreatic cancer, or its precursors,nin high-risk subjects could play a key role in reducing the burden of this disease, which is thenmost lethal among solid gastrointestinal tumors. Given the poor accessibility of the pancreasndue to its anatomic site, and given the limitations of imaging modalities, biomarker screeningnmight be a promising diagnostic option. This review focuses on the rationale of using stoolnmarkers for the early detection of pancreatic cancer, and systematically summarizes currentnevidence. Despite several potential advantages of stool testing for pancreatic cancer and itsnbiological plausibility, only six studies investigating two genetic markers in stool (the K-ras andnthe p53 gene) could be identified. Even though these studies were limited in size and couldnhardly approximate the screening setting, both markers appear to lack sensitivity and, innparticular, specificity. The investigation of further marker candidates (e.g., epigenetic markers)nin adequately designed studies represents an important next step to explore the potential ofnstool testing for pancreatic cancer. Pertinent studies could greatly benefit from recentnmethodological advances gained in connection with stool testing for colorectal cancer.