胰头癌早期论断的探讨

目的:探讨运用现代诊断方法早期诊断胰头癌的方法.方法:回顾分析我们收治的96例胰头癌的病例资料.结果:在各种检查中,对胰头癌的第三性依次是术中穿刺抽吸细胞学检查(FNA),ERCP,CT,血管造影(DSA),B超和CA19-9.结论:在各种检查中,首选B超和CT,对B超和CT不能确诊的病例,如无黄疸,宜行ERCP检查,如有黄疸,且排除了肝炎等情况,可直接剖腹探查,术中行FNA,以明确论断,而DSA在显著瘤侵犯血管程度从而判断能否切除肿瘤方面的有重要价值.

On early diagnosis of cancer in the head of pancreas

Objective To explore the means of early diagnosis of cancer inthe head of pancreas through the present diagnosis approaches.Methods The data of 37 patients (11with tumor resection) in our hospital from 1993 to 1998 and 59 patients (17 with tumor resection) in Shanghai Tumor Hospital from 1995 to 1997 were reviewed and analyzed.Results The diagnostic sensitivities of FNA , ERCP、CT、DSA and BUS decreased orderly.Conclusion In the diagnosis, BUS and CT shoud be the first choices. If the patient without jaundice is still not diagnosed by means of BUS and CT, ERCP should be used. Exploratory laparotomy should be considered for the patient with jaundice but without hepatitis. During the operations, FNA should be used to conefirm the diagnosis. Angiography is of great value in showing the degree of tumor invasion to blood vessels in order to decide whether the tumor could be removed or not。