Pancreas tumor brief introduction

Foreword

The pancreas is the organ which is located on belly cavity behind, is also digest a medical science in, is neglect more and easily before of one wreath;But it drive the reason for forget be unexpectedly because of dissecting place of honor backland, the physiology δ Chang fragrant Lou  ah Guo  does the Huai Di use  ?Yi)dirty, it of personal status just is really'deep temple hatred Fu'.But pancreas, but is the most important endocrine of human body and outside secrete organ, once its function appears an abnormality, will have digest symptoms and system to metabolize out of tune(for example:Impaired digestion symptoms, fat then, diabetes …), really it may be said'disease can not also'.The pancreas cancer is the most fatal in the pancreas disease, in recent years, the pancreas cancer has already jumped to reside ten one of the big death cancerses, and has gradual ascension of tendency, so need to add an attention especially.

Epidemiology

Pancreas cancer at west nation of fad rate, have 7-10 people each time about 100,000 people, recently 20~30 in the last yearses year by year incidence rate ascension, good hair at the male, black ratio white man many, as for it with the result that cause because of then become diverse, probably with smoke cigarette, the residue food of Gao Zhi Di, coffee take relevant, and drink to excess over a long period of time with chronic pancreas burning, also have a close pass connect sex.

Pathologic physiology

The pancreas cancer is consistently airtight and the fiber turn sex tumor, the familiar original hair tumor is a gland cell cancer, the last skin cell from Yi tube or gland building;Another then come from endocrine cell, for example Yi island cell lump(islet cell tumor), rise the sugar plain plain lump(somatostatinoma), VIPoma of the cell lump(glucagonoma), system …etc..Pancreas tumor's ising about 70% is so deliver in the Yi head, Yi body and Yi tail to then have rest 30%. And because pancreas is is empress the organ of the belly cavity, and the area, 12 bowels, stomach of the close by liver door, with horizontal colon, so easily deliver the above-mentioned organ to transfer; But Yi tail the tumor then relatively will transfer to the peritoneum chamber and the spleen.Because neighborhood blood vessel, lymphoid tube, and the nerve distribute intensively, so also the easily distant organ transfer.

Clinical symptoms

The symptom of pancreas cancer, often present the stomachache, backache of non- particularity, be disgusted with a food, weight to ease, the Xie Li, digest absorb badly, jaundice, and belly lump.The reason learns a check, to most patient's helps not big, main performance for last the stomach press pain, the jaundice, gall bladder be greatly swollen, top stomach lump etc.. Therefore want diagnose a pancreas cancer in early days, needed notice have as follows clinical omen:(1)Last stomachache or backache, like after coming from belly cavity, and the top appetite check but have no special detection,(2) the weight obviously ease,(3) gradually enter sex jaundice,(4) not clear reason pancreas burning, diabetes,(5) chronic Xie Li and the Top of Form fat then.

Diagnose

General blood and serology check particularity not high, the familiar liver function abnormality, starch 脢 and fat 脢 go up, or the blood sugar rises just. The tumor marking(tumor marker) check has the cancer Pei the original antigen(CEA), A type embryo's egg white(AFP), with the result that Yi cancer antigen(pancreatic oncofetal antigen) …, but still can't well diagnose a pancreas cancer in advance. Belly ultra sound(echo) and computer break a layer to photograph(CT scan), is equal sensitive and convenient check, not only can understand pancreas of dissect structure, with close by blood vessel and lymphoid knot a relation, more can understand partial organ(for example:Liver, Pi, colon, 12 bowels …)whether transfer, but the trillion of disease if too small(<1 cm), and Be located on Yi tail, is neglect easily. The nuclear magnetic resonance Dan Yi tube photograph(MRCP), as well in common use in detect Yi bile duct to jam a sexually transmitted disease to change of settle sex check.Inside see the mirror treacherous acts Dan Yi a tube to photograph(ERCP), this be the check of a kind of diagnosis and treatment, through build shadow Yi bile duct, understand narrow with jam of position and characteristic;More can by this make a slice, cytology check and even place inside, outside lead to flow a tube, with alleviate to jam.Be worn a liver and gall way to photograph(PTCD) by skin, aim at the extension jam of bile duct a sexually transmitted disease to change, use to wear to stab pipe needle at the X-light see through the mirror descend completion gall to lead to flow.Blood vessel's photograph(angiography) is a kind of invasion check, but it can provide detailed tumor blood vessel to be like, partial afferent invasion and wrap to clip, can lower the excision surgical operation of the non- necessity Pou stomach by this.

Cure

The treatment method that the pancreas cancer adopt depend on the cent of pancreas cancer to expect; Issue 1 only limits at pancreas, Issue 2 infringes upon to the close by organization, Issue 3 spreads to a partial wood to fawn on, Issue 4 has already transfer to the liver or more distance organ. But ignore to adopt any treatment, accept aggressive support and nourishment to look after is an inevitable demand of, face this disease, the adjustment of motion is very heavy burdens to all of the patient and the family memberses.

The essential treatment method is divided into 3 currently, the chemistry medicine cure,(three) and the radio projects light upon a treatment. In regard to surgical operation, most the Zhao be a Whipple resection, it includes Yi head, distant stomach, 12 bowels, gall bladder, top end jejunum excision, and the Yi, jejunum fit together, the stomach, jejunum fit together, the pneumogastric nerves cut in addition to etc.. But the surgical operation death rate reach to 12- 21%, the five years livability is also only 5- 7%.As for the appeasement surgical operation have, the Dan way rounds a surgical operation, belly cavity nerve cluster to stop etc.. Chemistry medicine treatment, can according to clinical cent expect dissimilarity, choose single or various combination medicine method treatment, but the medicine have 5-FU, carmustine(BCNU), lomustaine(CCNU), Stretozotocin, first step treatment reaction rate about 20- 30%, but the whole treatment effect be very low and estimate below 5%.Project line irradiation, the treatment is only used for lending support to sex treatment, currently still can't cure of don't cut off sex pancreas tumor, the general shines on a design quantity for about 4000- 5000 radses, if the medicine treatment of the match chemistry, can promote treatment result, but the whole treatment policy, should closely communicate with doctor, then can acquire the biggest advantage.