Zins Marc, Sauvanet Alain
Service de radiologie Institut mutualiste Montsouris 75014 Paris.
Rev Prat. 2002 Sep 15;52(14):1525-31.
Ductal carcinoma is the most frequent pancreatic neoplasm. The other tumours are cystic tumours, intraductal neoplasms, and endocrine tumours; some of these neoplasms have a malignant potential. Main symptoms of ductal carcinoma are epigastric pain, weight loss, and cholestatic jaundice for cephalic tumours; other tumours have varying symptoms and can be discovered fortuitously. Serum assay of CA 19-9 is neither sensitive nor specific for diagnosis of ductal carcinoma. For diagnosis of ductal carcinoma, helical CT scan has a 90% sensitivity and only fails to detect tumours less than 2 cm. Endoscopic ultrasound is efficient for diagnosis of small tumours and allows fine needle aspiration for pathological examination whatever tumour diameter. Staging (locoregional and metastatic extension) is mainly done by helical CT scan.
导管癌是最常见的胰腺肿瘤。其他肿瘤包括囊性肿瘤、导管内肿瘤和内分泌肿瘤；其中一些肿瘤具有恶变潜能。导管癌的主要症状为上腹部疼痛、体重减轻，对于胰头肿瘤还会出现胆汁淤积性黄疸；其他肿瘤症状各异，可能偶然被发现。CA 19-9血清检测对导管癌诊断既不敏感也不特异。对于导管癌的诊断，螺旋CT扫描敏感性为90%，仅无法检测出小于2厘米的肿瘤。内镜超声对小肿瘤诊断有效，无论肿瘤直径大小均可进行细针穿刺以获取病理检查样本。分期（局部和转移范围）主要通过螺旋CT扫描完成。
