胰腺癌早期诊断的临床分析264例  

Clinical analysis of early diagnosis of pancreatic carcinoma：report of 264 cases

作　　者：王树钢 于巍巍[1] 费立明[1] 

机构地区：[1]山东省烟台市烟台山医院 肝胆外科,山东烟台264001

出　　处：《世界最新医学信息文摘》2014年第13期8-9,共2页World Latest Medicine Information Electronic Version

摘　　要：目的：分析胰腺癌的临床特点,探讨胰腺癌的早期诊断方法。方法回顾总结我院肝胆外科2007年1月至2013年10月264例胰腺癌病人的临床特征，统计患者的首发症状和各种检查方法的阳性例数。结果首发症状以上腹痛、上腹不适、黄疸、厌食、体重减轻多见，出现病例数分别为153例（58.0%）、44例（16.7%）、51例（19.3%）、39例（14.8%）、33例（12.5%）。影像学检查阳性率为BUs 80.7%、ct84.8%、Mri78.6%、ercP89.5%、eUs79.4%、胃肠造影39.1%、dsa90.0%。ca19-9、ca242的阳性率为83.9%、61.4%。结论上腹痛、上腹不适是胰腺癌最常见的首发症状；血清学肿瘤标记物对诊断早期胰腺癌的价值不大，ca19-9、ca242对胰腺癌的诊断有一定的参考价值；BUs检查是首选的最佳检查方法；对临床上怀疑胰腺癌的患者，均应行ct或Mri检查；加强健康教育,重视患者首发症状,筛查临床胰腺癌高危人群患者,选用合理检查方法,可以提高胰腺癌早期诊断率。Objectiveto study the clinical characteristics of pancreatic cancer and to analysis the early diagnosis methods of pancreatic cancer.Methods the clinical data of 264 cases of pancreatic cancer admitted to our department between Jan.2007 and oct. 2013 were analyzed retrospectively.Resultsthe abdominal pain, abdominal discomfort,jaundice and anorexia , weight loss as initial symptoms were found in 153, 44, 51,39 and 33 cases respectively. the positive rate of image examination was80.7% with B ultrasound, 84.8% with ct,93.5% with Mri,89.5% with ercP,79.4% with eUs,39.1% with gastrointestinal series,78.6% with angiography .the positive rate of ca19-9 and ca242 was 83.9%、61.4%.Conclusionsstrengthening a healthy education ,emphasizing initial symptom ,checking clinical patients with predisposing factors of pancreatic cancer and choosing reasonable check method can improve the rate of early diagnosis of pancreatic cancer.

关 键 词：胰腺癌 早期诊断 影像学检查 肿瘤标志物 

分 类 号：R445.1[医药卫生—影像医学与核医学]