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胰腺癌是美国的第五大癌症死亡原因,全国每年因此病死亡者超过24000人.确诊后1年生存率不到20%,5年生存率仅3%.胰十二指肠根治切除术在60～70年代的死亡率很高而术后长期生存率很低.近年来,无论从诊断和处理方面均有明显进步,本文旨在报道近代处理胰腺癌的方法.病理:胰腺恶性病变中,95%发生于外分泌部分.大多起源于胰腺管系统,可见纤维结缔组织增生、胰腺炎和胰腺纤维化.组织学分类为腺癌.3/4发生在胰腺头颈部.胰体尾部癌诊断时多属晚期.胰腺囊性腺癌甚为少见.胰腺内分泌肿瘤分为功能性和无功能性,有良性和恶性的分别.胰腺淋巴瘤少见但认识很重要.诊断:胰腺癌早期表现为厌食,体重下降,腹部不适均属非特异性症状.当病变侵及周围组织结构则出现黄疸、疼痛或十二指肠梗阻,特异症状的出现已属进展期.15%～20%病人有新出现的糖尿病,偶可发生急性胰腺炎.早期诊断籍助于影像检查.近年来应用内镜超声检查技术,将高分辨探头置入胃或十二指肠腔以探测胰腺及其邻近器官,可以诊断<2cm的胰腺病变、肿大淋巴结及血管受累情况,诊断效果较超声扫描、CT、MRI优越,但此术尚难扩大应用.
Pancreatic cancer is the fifth leading cause of cancer death in the United States. More than 24,000 people die each year in the country. The 1-year survival rate after diagnosis is less than 20%, and the 5-year survival rate is only 3%. Pancreatic and duodenal radical resection is The mortality rate in the 1960s and 1970s was high and the postoperative long-term survival rate was very low. In recent years, both in terms of diagnosis and treatment, there have been significant advances. This article aims to report a modern method for the treatment of pancreatic cancer. Pathology: In pancreatic malignancies, 95% occurred in the exocrine part. Most originated in the pancreatic ductal system, visible fibrous connective tissue hyperplasia, pancreatitis and pancreatic fibrosis. Histological classification was adenocarcinoma. 3/4 occurred in the pancreatic head and neck. Pancreatic body and tail cancer diagnosis Mostly advanced. Pancreatic cystic adenocarcinoma is very rare. Pancreatic endocrine tumors are divided into functional and non-functional, with benign and malignant, respectively. Pancreatic lymphoma is rare but it is important to know. Diagnosis: Early manifestations of pancreatic cancer as anorexia, weight Fall, abdominal discomfort are non-specific symptoms. When the lesion invades the surrounding tissue structure, jaundice, pain, or duodenal obstruction appear. The appearance of specific symptoms is already in advanced stage. 15% to 20% of patients have newly developed diabetes. Occurrence may occur acutely Pancreatitis. Early diagnosis aids in imaging. In recent years, endoscopic ultrasonography has been used to place high-resolution probes into the stomach or duodenum to detect the pancreas and its adjacent organs. It can diagnose <2cm of pancreatic lesions and swollen lesions. Large lymph nodes and vascular involvement, the diagnostic effect is superior to ultrasound scan, CT, MRI, but this technique is still difficult to expand the application.