Hayakawa T, Kondo T, Shibata T, Kitagawa M, Katada N, Kato K, Takeichi M
Second Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Gastroenterol Jpn. 1990 Dec;25(6):727-31. doi: 10.1007/BF02779187.
Early detection of pancreatic cancer was prospectively evaluated by measuring serum immunoreactive elastase (IRE) in 722 patients in two hospitals during the past 18 months. Patients included in the study were over 40 years of age and had symptoms suggestive of pancreatic disease such as upper abdominal pain, discomfort or mass, jaundice, weight loss, or diabetes. Among the 722 patients, 171 exhibited elevation of serum IRE. Pancreatic diseases were subsequently found in 42% of the 171 patients. Pancreatic cancer was found in 22 patients, among which 17 had elevated serum IRE. Among the 17 pancreatic cancer patients with elevated IRE, 10 underwent radical resection of the cancer but in none of the five patients with normal serum IRE could radical resection be carried out. Three of the 10 patients had a small cancer less than 2 cm in diameter and two of them survived for more than three years. Patients over 40 or 45 years of age complaining of upper abdominal pain of recent onset that cannot be explained by diseases other than that of the pancreas would be candidates for measurement of serum elastase, and this is an effective way to detect pancreatic cancer at an early stages.
在过去18个月里，通过检测722例患者的血清免疫反应性弹性蛋白酶（IRE），对胰腺癌的早期检测进行了前瞻性评估。这些患者来自两家医院，年龄均超过40岁，且有提示胰腺疾病的症状，如腹痛、不适或肿块、黄疸、体重减轻或糖尿病。在这722例患者中，171例血清IRE升高。随后在这171例患者中的42%发现了胰腺疾病。发现22例胰腺癌患者，其中17例血清IRE升高。在17例血清IRE升高的胰腺癌患者中，10例行根治性癌切除术，而5例血清IRE正常的患者均无法进行根治性切除术。10例患者中有3例癌灶直径小于2cm，其中2例存活超过3年。40岁或45岁以上、近期出现无法用胰腺以外疾病解释的上腹部疼痛的患者，可作为检测血清弹性蛋白酶的对象，这是早期检测胰腺癌的有效方法。
