Modolell I, Guarner L, Malagelada J R
Digestive System Research Unit, Hospital General Vall d'Hebron, Barcelona, Spain.
Ann Oncol. 1999;10 Suppl 4:82-4.
Pancreatic and biliary carcinomas remain a challenge to clinicians and investigators, as diagnosis is rarely achieved while the tumor is still in a curative stage. Clinical symptoms and signs of these neoplasias are non-specific and heterogeneous. We review the clinical presentation of these tumors, with an emphasis on their pathophysiology and relationship with survival. Abdominal pain is the most common presenting complaint in pancreatic and biliary tract carcinomas, regardless of their size; although severe back pain usually indicates neural compromise, and is associated with a short survival. Jaundice may also be an early sign, in fact, pancreatic tumors that present as painless jaundice have been ascribed, a relatively more favorable prognosis. Weight loss is a common finding in most patients, being usually associated with malabsorption. These neoplasias may also present as diabetes, as an acute pancreatitis episode, with venous thrombosis or malignant thrombophlebitis, as a gastrointestinal hemorrhage, with mental disturbances, or skin manifestations.
胰腺癌和胆管癌仍然是临床医生和研究人员面临的挑战，因为在肿瘤仍处于可治愈阶段时很少能实现诊断。这些肿瘤的临床症状和体征是非特异性的且多种多样。我们回顾这些肿瘤的临床表现，重点关注其病理生理学以及与生存的关系。腹痛是胰腺癌和胆管癌最常见的主诉，无论肿瘤大小如何；尽管严重的背痛通常表明神经受压，且与生存期短相关。黄疸也可能是早期症状，事实上，表现为无痛性黄疸的胰腺肿瘤被认为预后相对较好。体重减轻在大多数患者中很常见，通常与吸收不良有关。这些肿瘤还可能表现为糖尿病、急性胰腺炎发作、静脉血栓形成或恶性血栓性静脉炎、胃肠道出血、精神障碍或皮肤表现。
