Pancreatic cancer mainly refers to malignant tumors originating from pancreatic duct and exocrine gland, and the degree of malignancy is extremely high. The etiology is still unclear, and it is believed to be related to many factors such as heredity and environment. ?

pathology

Angiogenic adenocarcinoma is the most common histological type. Pancreatic cancer is most common in the head of pancreas. ?

Pancreatic cancer is prone to early metastasis, including direct diffusion, lymphatic metastasis, hematogenous metastasis and nerve sheath metastasis. ?

Clinical manifestations?

The incidence of pancreatic cancer is hidden and there is no special manifestation in the early stage. ?

The most common symptoms of pancreatic head cancer are jaundice and abdominal pain, which are often accompanied by a certain degree of weight loss. Abdominal pain is mostly upper abdominal pain, and jaundice is obstructive jaundice, which is gradually aggravated. In patients with pancreatic cancer, jaundice is not common, while abdominal pain and back pain are more common, accompanied by obvious weight loss. Diabetes is sometimes the early clinical manifestation of pancreatic cancer. Patients with pancreatic cancer may have nausea, vomiting and intermittent low fever. ?

There were no obvious signs at the beginning of physical examination. Typical pancreatic cancer can be seen as emaciation, jaundice and upper abdominal tenderness. ?

Auxiliary inspection?

First, a blood test?

When jaundice occurs, serum bilirubin gradually increases, mainly combined bilirubin. ?

Second, tumor markers?

CA 19-9: the critical value is 37U/mL. ?

Third, imaging examination?

1.b-ultrasound: pancreatic tumors with a diameter of > 2 cm can be displayed. ?

2.CT: Spiral CT is the best method to diagnose and evaluate the scope of pancreatic cancer and determine the resectability of surgery, and can detect tumors with a diameter greater than 2 cm. ?

3.MRI: The sensitivity is slightly higher than that of CT. ?

4.ERCP (endoscopic retrograde cholangiopancreatography): mainly suitable for suspected pancreatic cancer patients with negative CT examination; Pancreatic cancer metastasis cannot be operated, and biliary stent drainage is needed to reduce jaundice. ?

5.EUS: Tumors with a diameter less than 2 cm can be detected. ?

Fourth, cytological examination?

It is suitable for patients who are suspected of pancreatic cancer and cannot be diagnosed, and need to prove the benign and malignant tumor by cytology to determine the treatment method. There is no false positive, but there is a false negative if there are too few samples. ?

Principles of treatment?

1. Surgical resection: the only possible way to cure pancreatic cancer. What is the standard surgical procedure? Whipple's resection? . ?

2. radiation therapy?

3. chemotherapy?

4. Symptomatic treatment