Elli Marco, Piazza Elena, Franzone Paola Colli, Isabella Luigi, Poliziani Dario, Taschieri Angelo M
Università degli Studi di Milano Ospedale Luigi Sacco, via G.B. Grassi, 72, 20157 Milano, Italy.
Hepatogastroenterology. 2003 Nov-Dec;50(54):2205-7.
BACKGROUND/AIMS: Pancreas carcinoma is seldom recognized at an early stage. Through an attentive retrospective evaluation of the patient's history a frequent pattern of early presentation is sought.
A series of 64 patients (36 males; 28 females) with histologically proven pancreas carcinoma seen in the Department of Surgery and the Oncology Department of the University of Milan (Ospedale "L. Sacco") in the years 1992 through 2001, is closely scrutinized, tracing the very initial signs and symptoms in each individual case.
Weight loss is by far the most frequent early complaint, being the presenting symptom in more than 79% of cases, either alone or associated with one or more additional symptoms, followed by pain (56%), anorexia (28%), jaundice (25%) and asthenia (23%). However it appears that weight loss is often overlooked until other more suggestive symptoms ensue. In particular, slowly developing jaundice was the most common indication for ultrasound scan or computed tomography study, although jaundice was the presenting symptom in only 25% of cases.
In patients presenting with unexplained weight loss, a more liberal use of diagnostic imaging techniques in the upper abdomen might be advisable.
背景/目的：胰腺癌很少在早期被识别。通过对患者病史进行细致的回顾性评估，寻找常见的早期表现模式。
对1992年至2001年期间在米兰大学（“L. Sacco”医院）外科和肿瘤科就诊的64例经组织学证实为胰腺癌的患者（36例男性；28例女性）进行了仔细审查，追溯每个病例最初的体征和症状。
体重减轻是迄今为止最常见的早期主诉，超过79%的病例以此为首发症状，可单独出现或伴有一种或多种其他症状，其次是疼痛（56%）、厌食（28%）、黄疸（25%）和乏力（23%）。然而，在出现其他更具提示性的症状之前，体重减轻往往被忽视。特别是，尽管黄疸仅在25%的病例中作为首发症状，但缓慢进展的黄疸是超声检查或计算机断层扫描最常见的指征。
对于出现不明原因体重减轻的患者，更广泛地应用上腹部诊断性影像学检查可能是可取的。
