Ozaki H, Kinoshita T, Kosuge T, Shimada K, Yamamoto J, Inoue K
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Gan To Kagaku Ryoho. 1992 Dec;19(14):2311-8.
The prognosis for ductal cancer of the pancreas is extremely poor. Diagnosis of pancreatic cancer in the earlier stages has become possible by taking note of early symptoms, mild abdominal pain, back pain, anorexia, diabetes and obstructive jaundice. Presently, measurements of amylase in serum and urine, serum elastase-1, serum CA 19-9 and US are usually used for screening patients with the symptoms. Furthermore, for correct diagnosis, intensive study by US, dynamic CT, ERCP, MRI, cytological examination and CEA of pancreatic juice, endoscopic pancreatoscopy and endoscopic ultrasonography are used. The results of surgical treatment for resectable pancreatic cancer are not generally favorable. Extended pancreatic resection (pancreatoduodenectomy, total pancreatectomy or distal pancreatectomy) with en bloc dissection of the lymph nodes has been performed for patients with invasive cancer. However, local recurrence and distant metastasis usually occurred after surgery. It seems difficult to cure pancreatic cancer by surgery alone. To improve the prognosis of resectable pancreatic cancer, multimodality treatment with intraoperative radiation therapy and chemotherapy is performed and a better outcome is achieved.
胰腺导管癌的预后极差。通过留意早期症状，如轻度腹痛、背痛、厌食、糖尿病和梗阻性黄疸，胰腺癌的早期诊断已成为可能。目前，血清和尿液淀粉酶、血清弹性蛋白酶-1、血清CA 19-9检测以及超声检查通常用于筛查有这些症状的患者。此外，为了准确诊断，还会采用超声、动态CT、内镜逆行胰胆管造影（ERCP）、磁共振成像（MRI）、胰液细胞学检查和癌胚抗原（CEA）检测、内镜胰腺检查以及内镜超声检查等深入研究手段。可切除胰腺癌的手术治疗结果总体上并不理想。对于浸润性癌患者，已实施扩大性胰腺切除术（胰十二指肠切除术、全胰切除术或胰体尾切除术）并整块清扫淋巴结。然而，术后通常会出现局部复发和远处转移。似乎仅通过手术难以治愈胰腺癌。为改善可切除胰腺癌的预后，会采用术中放射治疗和化疗的多模式治疗，并取得了更好的效果。
