Furukawa H, Okada S, Saisho H, Ariyama J, Karasawa E, Nakaizumi A, Nakazawa S, Murakami K, Kakizoe T
Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan.
Cancer. 1996 Sep 1;78(5):986-90. doi: 10.1002/(SICI)1097-0142(19960901)78:5<986::AID-CNCR7>3.0.CO;2-A.
Early diagnosis and complete removal of pancreatic adenocarcinoma (PC) is essential to improve its poor prognosis. It is necessary to find PC when it is small and at an early stage if surgical treatment is to be successful. This is an investigation of the clinicopathologic features of small PC.
Thirty-one resected and histopathologically examined cases of small PC, 2 cm or less in greatest dimension, were collected from 7 institutions between 1989 and 1994, and their clinicopathologic features were analyzed in detail.
Eighteen patients (58.1%) had some symptoms or signs at the time of diagnosis, however, the other 13 (41.9%) had no symptoms. There was no sensitive blood test for the detection of small PC. The detection rates of the pancreatic tumor mass on ultrasonography, endoscopic ultrasonography, and computed tomography were 64.5% (20/31), 73.7% (14/19), and 64.5% (20/31), respectively. Only 13 patients (41.9%) were in International Union Against Cancer (UICC) Stage I, and the other 18 were in Stage III or IV due to lymph node metastasis or peritoneal dissemination. The overall 4-year postoperative survival rate was 54.5% and that of patients in Stage I was 77.9%.
To detect a small PC, a thorough examination may be required in patients with slightly abnormal findings on laboratory tests or imaging modalities, even if the patient is asymptomatic. PC 2 cm or less and belonging to Stage I may be regarded as an early carcinoma, because of its good prognosis.
早期诊断并完整切除胰腺腺癌（PC）对于改善其不良预后至关重要。若要使手术治疗成功，有必要在PC处于小而早期阶段时将其发现。这是一项关于小PC临床病理特征的研究。
收集了1989年至1994年间来自7家机构的31例经手术切除并经组织病理学检查的小PC病例，其最大直径为2厘米或更小，并对其临床病理特征进行了详细分析。
18例患者（58.1%）在诊断时出现了一些症状或体征，然而，另外13例（41.9%）没有症状。没有用于检测小PC的敏感血液检测方法。超声检查、内镜超声检查和计算机断层扫描对胰腺肿瘤肿块的检出率分别为64.5%（20/31）、73.7%（14/19）和64.5%（20/31）。只有13例患者（41.9%）处于国际抗癌联盟（UICC）I期，另外18例因淋巴结转移或腹膜播散而处于III期或IV期。术后总体4年生存率为54.5%，I期患者的生存率为77.9%。
为了检测小PC，对于实验室检查或影像学检查结果略有异常的患者，即使患者无症状，也可能需要进行全面检查。直径2厘米或更小且属于I期的PC因其预后良好，可被视为早期癌。
