胰腺癌的早期诊断和治疗进展

Advances in early diagnosis and therapy of pancreatic cancer

胰腺癌(pancreatic cancer,PC)是恶性程度很高的肿瘤,5年生存率低于5%。由于其发病隐匿,确诊时已到晚期,仅有约10%-20%的患者能行手术根治。CT是PC诊断和分期的影像学依据。近年来随着磁共振成像和超声内镜技术的发展,为PC的诊断提供了更精确的影像学资料,尤其对局部浸润和淋巴结转移的患者。手术切除是仅有的根治手段。近十年来,吉西他滨已成为晚期PC的标准化疗法,以吉西他滨为基础的联合化疗,尤其是同分子靶向因子的联合治疗是有前途的。辅助放射治疗仍有争论,但随着放射运载技术的发展,放射治疗将会被越来越多的用于临床。姑息治疗的目的是为了缓解疼痛和改善恶性肿瘤所造成的恶液质。本文就PC早期诊断及治疗进展作一综述。

Pancreatic cancer（PC）remains a devastating disease with a 5 - year survival rate of less than 5% . It has an insidious onset and as a result presentation is usually late,with only about 10% - 20% of patients having disease amenable to surgical resection. With recent advances in magnetic resonance imaging and endoscopic ultrasonography, it is now possible to improve the accuracy of preoperative staging,particularly with respect to local invasion and re-gional node involvement. Resection is the only treatment that offers the potential of cure. Over the past decade,the gemcitabine has been established as a chemotherapeutic standard in the treatment for advanced PC. Gemcitabine -based combination chemotherapy,especially molecular targeted therapy in pancreatic carcinoma is promising. The use of adjuvant radiotherapy for pancreatic cancer,however,is controversial. But with the development of modern radiation delivery techniques radiotherapy will be more and more used. Palliative therapies are aimed at controlling pain and re-versing cancer cachexia. This paper reviews the advances of pancreatic cancer early diagnosis and therapy.