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目的 了解胰腺癌临床诊断特点 ,提高胰腺癌早期诊断率。方法 回顾性研究 1990年～ 2 0 0 0年胰腺癌住院患者 70例 (男 4 8例 ,女 2 2例 ,年龄 :36～ 83岁 ,平均年龄 6 3 7岁 )。结果 临床分期 :Ⅰ～Ⅱ期 8例占11 4 %。有症状后仅 4 0例 (5 7 1% )患者在一月内就诊 ,其中 19例 (2 7 1% )在有症状后一月内得到确诊 ,Ⅰ～Ⅱ期为 5例 (2 6 3% )。胰腺癌的首发症状多为腹痛 5 2例 (74 3% )、黄疸 7例 (10 1% )、上腹不适 4例 (5 8% )等。 4 0例 (5 7 1% )患者曾误诊为其它疾病 ,多为慢性胃炎 15例、慢性胆囊炎 5例、溃疡病 4例等。CA199升高 16 / 18例(88 9% ) ,CA12 5升高 6 / 7例 (85 7% ) ,其中 3例Ⅰ～Ⅱ期患者仅CA12 5升高。 5例在确诊前 5个月内因血糖升高诊断糖尿病。结论 胰腺癌确诊时中晚期占大多数 ,就诊晚、误诊、胰腺癌发展快为其主要原因。首发症状多为腹痛、黄疸、上腹不适等 ,慢性胃炎、胆囊炎、溃疡病为误诊的主要疾病。CA199、CA12 5升高对胰腺癌敏感性较高 ,应重视CA12 5、血糖升高的早期诊断价值。
Objective To understand the clinical features of pancreatic cancer and improve the early diagnosis rate of pancreatic cancer. Methods A retrospective study of 70 hospitalized patients with pancreatic cancer between 1990 and 2000 (48 males and 22 females, aged 36-83 years, mean age 6.37 years) was performed. Results Clinical stage: Ⅰ ~ Ⅱ 8 cases accounted for 114%. Only 40 (51.7%) patients were treated within one month after symptom onset, of which 19 (271%) were diagnosed within one month after symptom onset and 5 (Ⅰ, Ⅱ) %). The first symptom of pancreatic cancer were abdominal pain 52 cases (74.3%), jaundice 7 cases (101%), abdominal discomfort in 4 cases (58%) and so on. 40 patients (57.1%) had misdiagnosed as other diseases, mostly chronic gastritis in 15 cases, 5 cases of chronic cholecystitis, 4 cases of ulcer disease. CA199 increased 16/18 (88.9%), CA12 5 increased 6/7 (85.7%), of which 3 cases of stage Ⅰ ~ Ⅱ only CA12 5 increased. Five patients were diagnosed with diabetes due to elevated blood sugar within the first 5 months of diagnosis. Conclusion The diagnosis of pancreatic cancer in the late majority, late treatment, misdiagnosis, rapid development of pancreatic cancer is the main reason. The first symptoms are mostly abdominal pain, jaundice, abdominal discomfort, chronic gastritis, cholecystitis, ulcer disease is the main misdiagnosis of the disease. CA199, CA12 5 high sensitivity to pancreatic cancer should pay attention to CA12 5, the early diagnosis of elevated blood glucose value.