Bosseckert H
Klinik für Innere Medizin I der Friedrich-Schiller-Universität Jena.
Zentralbl Chir. 2003 May;128(5):368-74. doi: 10.1055/s-2003-40029.
The possibilities which actually exist in order to obtain an earlier diagnosis in pancreatic carcinoma, a better differentiation of mass-forming pancreatitis and of other pancreatic tumors and an improved staging for reducing unnecessary operations are presented and evaluated. Possible relevant hints of the history and indicators for diagnostic procedures in view of a pancreatic carcinoma are upper abdominal complaints especially in relation to a new developed diabetes mellitus and/or unexplained elevations of pancreatic enzymes. The endosonography in combination with a target biopsy is of important value as well for the diagnosis of pancreatic cancer as for differentiation against a segmental chronic pancreatitis. In cases where differentiation is impossible even intraoperatively, we recommend the use of intraoperative fine needle biopsy.
本文介绍并评估了为实现胰腺癌早期诊断、更好地区分肿块型胰腺炎和其他胰腺肿瘤以及改善分期以减少不必要手术而实际存在的可能性。鉴于胰腺癌,病史中可能的相关线索和诊断程序的指标是上腹部不适,尤其是与新发生的糖尿病和/或不明原因的胰腺酶升高有关。超声内镜检查结合靶向活检对于胰腺癌的诊断以及与节段性慢性胰腺炎的鉴别均具有重要价值。在即使术中也无法进行鉴别的情况下,我们建议使用术中细针活检。