Ozaki H, Ishii K, Sato T, Karasawa E, Kitamura T, Tsuchiya R, Kasugai T, Abe M, Ueda M, Takeuchi T
Jpn J Clin Oncol. 1985 Mar;15(1):115-20.
A retrospective analysis was performed to evaluate the clinical symptoms and abnormal test findings in small pancreatic carcinoma. Five hundred and thirty-six cases of pancreatic carcinoma with the histology of duct cell carcinoma were collected from 14 medical centers in Japan. In 440 of the cases, tumor size was measured at the time of laparotomy or from the resected specimen. Three hundred and seventy-seven patients (86%) had a carcinoma larger than 3.0 cm; only 30% of these were resectable. Sixty-three patients (14%) had a carcinoma of 3.0 cm or less, with resectability of 97%. Detecting a tumor of "3 cm or less" with a high probability of resectability is the objective of early diagnosis with the resulting possibility of a cure. In most cases these small carcinomas were found easily when obstructive jaundice was present (73%). However, the estimated occurrence of obstructive jaundice associated with carcinomas of 3 cm or less was only 10% among the total cases of pancreatic carcinoma studied. Therefore, it is necessary for early diagnosis to detect carcinomas of 3 cm or less presenting without jaundice. The symptoms of small carcinoma without jaundice are weight loss, anorexia, upper abdominal pain, back pain and a palpable abdominal mass. Among the various available examinations, endoscopic retrograde cholangiopancreatography, computerized tomography and ultrasonography were valuable in diagnosing these small carcinomas.
进行了一项回顾性分析，以评估小胰腺癌的临床症状和异常检查结果。从日本14个医疗中心收集了536例组织学类型为导管细胞癌的胰腺癌病例。其中440例在剖腹手术时或从切除标本中测量了肿瘤大小。377例患者（86%）的癌灶大于3.0 cm；其中只有30%可切除。63例患者（14%）的癌灶为3.0 cm或更小，可切除率为97%。早期诊断的目标是高概率地检测出“3 cm或更小”且可切除的肿瘤，从而有可能治愈。在大多数情况下，当出现梗阻性黄疸时，这些小癌灶很容易被发现（73%）。然而，在研究的所有胰腺癌病例中，与3 cm或更小的癌灶相关的梗阻性黄疸估计发生率仅为10%。因此，早期诊断必须检测出无黄疸表现的3 cm或更小的癌灶。无黄疸小癌灶的症状包括体重减轻、厌食、上腹部疼痛、背痛和可触及的腹部肿块。在各种可用的检查中，内镜逆行胰胆管造影、计算机断层扫描和超声检查对诊断这些小癌灶很有价值。
