Diagnosis and clinical staging of pancreatic cancer
- VernacularTitle:胰腺癌的诊断和临床分期
- Author:
Wenhui LOU
- Publication Type:Journal Article
- Keywords:
pancreatic cancer;
diagnosis;
staging
- From:
China Oncology
2009;19(8):565-569
- CountryChina
- Language:Chinese
-
Abstract:
The incidence and prevalence of pancreatic cancer have been steadily increasing globally and domestically. The common risk factors of pancreatic cancer include diabetes mellitus, chronic panereatitis, cigarette smoking, family history of pancreatic cancer, and alcoholism. There is no specific symptom and early diagnostic marker of pancreatic cancer. CA19-9 is the most commonly used serum marker for the detection and follow-up of pancreatic cancer. However, its sensitivity and specificity precluded its use in screening of the disease. Enhanced spiral CT scan is the routine radiological modality for the diagnosis and staging of pancreatic cancer. Newly developed diagnostic modality such as ultrasound contrast imaging, endoscopic ultrasound, PET/CT scan further improved the sensitivity and specificity of diagnosis. Preoperative fine needle aspiration (FNA) is not recommended for patients with resectable pancreatic cancer. Pathological confirmation by FNA is necessary for patients who will be treated by chemotherapy or chemoradiotherapy. Preoperative staging laparoscopy can rule out the patients with abdominal seeding, so that unnecessary open surgery is avoided. In order to achieve better survival, every effort should be made to achieve R_0 resection for patients with stage Ⅰ or Ⅱ disease.
