摘要
目的目前CA199,CT和ERCP被认为是诊断胰腺疾病的常规检查手段。然而仍存在有慢性胰腺炎背景的胰腺癌与慢性胰腺炎鉴别诊断的误诊问题。认识常规检查手段的局限性对提高两种疾病的诊断十分必要。方法我们回顾分析了过去6年间因高度怀疑胰腺癌接受胰腺切除术的24例病人包括CA199的化验检查,CT,ERCP病史资料。最终诊断依据组织学。结果最终诊断结果有慢性胰腺炎背景的胰腺癌9例,类似肿瘤性胰腺炎13例,胰腺腺瘤合并慢性胰腺炎2例。临床资料,化验检查无鉴别诊断意义。CA199>37U/ml胰腺癌4例,慢性胰腺炎3例;两种疾病的CT,ERCP影像学相似。结论CA199,CT,和ERCP对有慢性胰腺炎背景的胰腺癌诊断价值有限。为明确诊断进一步发掘其它的特异性检查手段。
Objective To investigate the limitations of routine diagnostic methods of CT, ERCP and CA_~19-9 in differentiating pancreatic cancer coexisting with chronic pancreatitis (CP) from CP. Methods The clinical data including history, CA_~19-9 value and CT and ERCP images of 24 patients receiving pancreatectomy in our hospital over a period of 6 years were retrospectively analyzed for evaluation of suspected pancreatic cancer. The final diagnoses were obtained by histological confirmation. Results The final diagnoses were pancreatic cancer coexisting with CP in 9 patients and CP with coexisting with a focal inflammatory mass in the other 15. The history and laboratory tests were of little value in differentiating pancreatic cancer and CP. CA_~19-9 value was over 37 U/ml in 4 patients with pancreatic cancer and 3 with CP. CT and ERCP images were similar in all the patients. Conclusions CA_~19-9 value and CT and ERCP images were of limited value for diagnosis of pancreatic cancer coexisting with CP. Therefore, other specific methods should be further developed for its diagnosis.
出处
《中华肝胆外科杂志》
CAS
CSCD
2004年第12期802-804,共3页
Chinese Journal of Hepatobiliary Surgery
