췌장암의 내시경적 진단

초록

Purpose: Pancreatic cancer remains a major clinical challenge due to its high mortality rate and limited treatment options. Timely diagnosis is crucial for improving survival; however, its aggressive nature and anatomical location often delay detection. In this context, advanced endoscopic techniques have emerged as essential tools for evaluating pancreatic cancer. Current Concepts: Endoscopic ultrasound (EUS) plays a key role by providing high-resolution images and enabling tissue acquisition through fine-needle aspiration or biopsy-both safe and effective methods for obtaining diagnostic specimens from pancreatic lesions. Adjunctive techniques, such as contrast-enhanced EUS and elastography, further enhance evaluation by assessing vascularity and tissue stiffness. Additionally, endoscopic retrograde cholangiopancreatography (ERCP) holds a critical role, particularly in patients with obstructive jaundice. ERCP facilitates delineation of pancreatic and bile duct anatomy and enables cytologic and histologic sampling via brush cytology or forceps biopsy. Although technologies such as cholangioscopy and probe-based confocal laser endomicroscopy have been introduced to increase diagnostic yield, their routine clinical use remains limited. Furthermore, emerging applications of artificial intelligence (AI) in both EUS and ERCP are being integrated to support image interpretation and reduce operator dependency. Discussion and Conclusion: The synergistic use of EUS and ERCP has advanced the diagnostic strategy for pancreatic cancer by improving early detection and guiding treatment strategies. Ongoing improvements in imaging techniques, molecular diagnostic methods, and AI tools are expected to further enhance diagnostic accuracy, facilitating the development of personalized therapeutic approaches, ultimately leading to better patient outcomes.

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