胰头癌的早期诊断

早期诊断和早期治疗是提高胰头癌治疗效果的关键。为探讨临床各种诊断手段在小胰头癌诊断中的意义，回顾分析了８４例根治性手术中肿瘤≤２ｃｍ和＞２ｃｍ两组患者间的临床表现、影像学检查、血清学检查结果及其在小胰头癌诊断中的地位和作用。临床首现症状以黄疸、上腹部痛常见，但组间无差异。ＥＲＣＰ的诊断准确率明显高于Ｂ超（Ｐ＜０．０５）和ＣＴ（Ｐ＞０．０５），同时对小胰头癌的敏感性均高于Ｂ超（Ｐ＜０．０５）和ＣＴ（Ｐ＞０．０５），而Ｂ超和ＣＴ在诊断２ｃｍ以上胰头癌时有较高的确诊率。ＣＡ１９－９对小胰头癌的敏感性高于ＣＥＡ（Ｐ＜０．０１），但早期的确诊率仅为４２％。作者认为，重视胰头癌的临床表现是早期诊断的基础，合理的选择影像学检查是提高小胰头癌诊断准确率的关键，ＥＲＣＰ是诊断小胰头癌的有效手段。

Early diagnosis or the cancer in the head of the pancreas

In order to evaluate individual diagnostic means in terms of verifying small cancer of the head of the pancreas,we reviewed 84 patients with the cancer in the head of the pancreas undergoing radical resection.Patients were devided into two groups according to the tumor diameter(<2cm and>2cm).Jaundice and epigastric pain predominated in first-shown symptoms among all patients. The diagnosis accuracy of ERCP was apparently higher than BUS (P<0. 05)and CT (P>0. 05),while the sensitivity of ERCP for small tumor was also higher than BUS (P<0. 05) and CT (P>0. 05).The sensitivity of CA19-9 was significantly higher than CEA,but it had only a 42 % of accuracy in diagnosing small tumor. The authors concluded that paying more attention to the early manifestations is the basis in early diagnosing the cancer in the head of the pancreas,and reasonable selecting the image techniques is the key to improve the accuracy in diagnosing small tumors. ERCP has high value in early diagnosis.