AIM:To summarize progress in the study of K-ras gene studies in pancreatic cancer and its potential clinical significance in screening test for early detection of pancreatic cancer,and to differentiate pancreatic canc...AIM:To summarize progress in the study of K-ras gene studies in pancreatic cancer and its potential clinical significance in screening test for early detection of pancreatic cancer,and to differentiate pancreatic cancer from chronic pancreatitis in recent decade.METHODS:Literature search (MEDLINE 1986-2003) was performed using the key words K-ras gene, pancreatic cancer, chronic pancreatitis, and diagnosis. Two kind of opposite points of view on the significance of K-ras gene in detection early pancreatic cancer and differentiation pancreatic cancer from chronic pancreatitis were investigated.The presence of a K-ras gene mutation at codon 12 has been seen in 75-100% of pancreatic cancers, and is not rare in patients with chronic pancreatitis, and represents an increased risk of developing pancreatic cancer. However,the significance of the detection of this mutation in specimens obtained by needle aspiration from pure pancreatic juice and from stools for its utilization for the detection of early pancreatic cancer, and differentiation pancreatic cancer from chronic pancreatitis remains controversial.CONCLUSION:The value of K-ras gene mutation for the detection of early pancreatic cancer and differentiation pancreatic cancer from chronic pancreatitis remains uncertains in clinical pratice. Nevertheless, K-ras mutation screening may increase the sensitivity of FNA and ERP cytology and may be useful in identifying pancreatitis patients at high risk for developing cancer, and as a adjunct with cytology to differentiate pancreatic cancer from chronic pancreatitis.展开更多
AIM:To determine the perigastric lymph node involvement in periampullar tumors, in an attempt to optimize the surgical treatment of pylorus- preserving pancreatoduodenectomy.METHODS: We retrospectively investigated th...AIM:To determine the perigastric lymph node involvement in periampullar tumors, in an attempt to optimize the surgical treatment of pylorus- preserving pancreatoduodenectomy.METHODS: We retrospectively investigated the frequence of lymph nodes involvement in pedgastric regions. Distribution and number of involved lymph nodes were exambined from 112 patients with carcinoma of pancreas, 59 patients with distal bile duct carcinoma, and 41 patients with carcinoma of the papilla of Vater.RESULTS:The frequency of lymphatic spread of carcinoma in pancreas; distal bile duct and papilla of Vater was 18.7%,1.9%,2.5% respectively. With regard to the mode of lymphatic spread in perigastric region, Infrapyloric nodes of carcinoma of the head of pancreas predominated over others,in carcinomas of the distal bile duct and the papilla of Vater,the left gastlic artery, and the greater curvature lymph nodes was the only sole sites, respectively.CONCLUSION: Understanding perigastric lymphatic involvement in periampullary tumors may be helpful for choosing the appropriate surgical approaches to pancreatoduodenectomy with preservation of pylorus.展开更多
文摘AIM:To summarize progress in the study of K-ras gene studies in pancreatic cancer and its potential clinical significance in screening test for early detection of pancreatic cancer,and to differentiate pancreatic cancer from chronic pancreatitis in recent decade.METHODS:Literature search (MEDLINE 1986-2003) was performed using the key words K-ras gene, pancreatic cancer, chronic pancreatitis, and diagnosis. Two kind of opposite points of view on the significance of K-ras gene in detection early pancreatic cancer and differentiation pancreatic cancer from chronic pancreatitis were investigated.The presence of a K-ras gene mutation at codon 12 has been seen in 75-100% of pancreatic cancers, and is not rare in patients with chronic pancreatitis, and represents an increased risk of developing pancreatic cancer. However,the significance of the detection of this mutation in specimens obtained by needle aspiration from pure pancreatic juice and from stools for its utilization for the detection of early pancreatic cancer, and differentiation pancreatic cancer from chronic pancreatitis remains controversial.CONCLUSION:The value of K-ras gene mutation for the detection of early pancreatic cancer and differentiation pancreatic cancer from chronic pancreatitis remains uncertains in clinical pratice. Nevertheless, K-ras mutation screening may increase the sensitivity of FNA and ERP cytology and may be useful in identifying pancreatitis patients at high risk for developing cancer, and as a adjunct with cytology to differentiate pancreatic cancer from chronic pancreatitis.
文摘AIM:To determine the perigastric lymph node involvement in periampullar tumors, in an attempt to optimize the surgical treatment of pylorus- preserving pancreatoduodenectomy.METHODS: We retrospectively investigated the frequence of lymph nodes involvement in pedgastric regions. Distribution and number of involved lymph nodes were exambined from 112 patients with carcinoma of pancreas, 59 patients with distal bile duct carcinoma, and 41 patients with carcinoma of the papilla of Vater.RESULTS:The frequency of lymphatic spread of carcinoma in pancreas; distal bile duct and papilla of Vater was 18.7%,1.9%,2.5% respectively. With regard to the mode of lymphatic spread in perigastric region, Infrapyloric nodes of carcinoma of the head of pancreas predominated over others,in carcinomas of the distal bile duct and the papilla of Vater,the left gastlic artery, and the greater curvature lymph nodes was the only sole sites, respectively.CONCLUSION: Understanding perigastric lymphatic involvement in periampullary tumors may be helpful for choosing the appropriate surgical approaches to pancreatoduodenectomy with preservation of pylorus.
