胰腺癌恶性程度高，早期诊断率低，是预后较差的消化系统肿瘤。癌症恶病质、肌肉及脂肪组织消耗是影响胰腺癌病人手术并发症与长期预后的重要因素。胰腺癌恶病质的发生，一方面与机体摄食减少有关；另一方面，肿瘤高代谢特点、多种炎症因子、脂肪及蛋白代谢调控因子、多条神经内分泌通路均参与胰腺癌恶病质及组织消耗的发生发展。目前对于胰腺癌恶病质及组织消耗的认识仍不全面，诊断方法亦不统一，筛查主要以体质量指数为主，但此方法对于肥胖症病人的适用性差，血清学细胞因子的检测及基于腹部CT平扫检查的肌肉脂肪含量测定等在胰腺癌恶病质的诊断中具有重要价值。围术期积极纠正组织消耗，对于减少手术并发症，改善病人预后有重要临床意义。目前尚无有效的方法完全逆转癌症恶病质，治疗上通常采用多模式治疗方案，手术治疗去除病因是缓解恶病质进展的根本措施；加强营养支持、减轻机体炎症及应激反应、减少骨骼肌消耗在围术期恶病质的治疗过程中亦十分重要。笔者综合分析国内外相关研究进展并结合自身经验，总结胰腺癌病人组织消耗的病因、分子机制、诊断及围术期治疗方案，探讨胰腺癌病人组织消耗与围术期处理策略。“,”Pancreatic cancer is a highly malignancy of the digestive system, with low early diagnosis rate and poor prognosis. Cancer cachexia, muscle and adipose tissue wasting are important factors affecting surgical complications and long-term prognosis of patients with pancreatic cancer. On one hand, the occurrence and development of pancreatic cancer cachexia are associated with the decrease of food intake. On the other hand, the characteristic of tumor hypermetabolism, many inflammatory factors, fat and protein regulatory factors and many neuroendocrine pathways are also involved in pancreatic cancer cachexia. At present, the understanding of cancer cachexia and tissue wasting is not comprehensive, and the diagnostic methods are not unified. The main screening method is based on body mass index, but it is not applicable to obese patients. The detection of serum cytokines and determination of intramuscular fat content based on the abdominal computed tomography scan also play pivotal roles in the diagnosis of pancreatic cancer cachexia. Perioperative inhibition of tissue wasting can not only reduce surgical complications, but also improve the prognosis of pancreatic cancer patients. However, there is no effective method to completely reverse cancer cachexia. Multidisciplinary treatment is the routine therapy. Surgical treatment to remove the tumor is the fundamental measure to impede the development of cachexia. In addition, strengthening nutritional support, reducing inflammation and stress reaction, reducing the muscle wasting are also important in the treatment of cachexia during the perioperative period. Combined with self experience, the authors comprehensively analyze research advances, summarize the etiology, molecular mechanism, diagnosis and treatment of tissue wasting, in order to investigate tissue wasting and perioperative treatment strategies of pancreatic cancer patients.