Pancreas cancer --Cancer _ general knowledge of tubular gland

Pancreas cancer --Cancer _ general knowledge of tubular gland
Tumour of exocrinosity of pancreas comes from the pancreas and is in charge of cells and gland afterbirth cells. Endocrine tumour is secreted cells to happen by Langerhans' islits and gastrin, much hormone emerges frequently.
Exocrinosity tumour
Tubular gland cancer
Gland cancer of the pancreas of exocrinosity is managed 9 times more of persons who are relatively taken place by gland bubble cells of persons who happen of cell by the pancreas. 80% happen on the pancreas head. It is 55 years old that the mean age of cancerous swelling happens, men exceed 1.5~2.0 times of women.
Symptom and physical sign
Symptom did not appear until later stage of disease, when diagnosing and establishing, already some progress of tumour of 90% of the patients, and the peritoneum structure, spread to some lymph node or shift the liver or lung after involving directly. The weight lightens and suffers from abdominal pain, the patient in most later period appears. The intersection of gland and cancer might cause getting obstructive jaundice, if tumour lie in body departments and tails of pancreas, may cause the intersection of spleen and vein block, huge the intersection of spleen and disease, stomach and esophagus variceal and gastrointestinal tract bleed. Most patients have serious going on upper abdomens to pain, often radiate to the back. Though pain of pancreas cancer is lightened through curly body posture or the simulation foetus' posture, but all patients need to anaesthetize antalgesic finally.
Diagnosis
The inspection result of routine test lab is often normal. If have bile ducts are blocked or the liver is shifted, there is rising of alkaline phosphatase and bilirubin. Hyperglycemia can be seen to 25%~50% of the patients; Overwhelming majority to continue, send on the intersection of pancreas and cancer among them, can also rise with long-term cancer morbidity of pancreas of diabetic, especially women patient. The relevant antigen of pancreas, including monoclonal antibody CA19-9, CA50, DU-PAN-2, SPAN-1, PCAA, embryo antigen of cancer and pancreas tumour fetus antigen, not reliable, because these indexes are not having limitation pancreas cancering shifted that is not rising, in can rise too in the the intersection of pancreas and patient. In some cases, they may contribute to the definite diagnosis of pancreas cancer, the differentiation of the good malignant pancreas disease and treatment of cancerous swelling patient, because to the pancreas cancer patient who is already made a definite diagnosis of, its density is raised, brief on disease progress.
Accuracy and expense effect best method to carry on CT check at first the most. If CT check pathological change of shifting etc. can't excised to find, can puncture, make histology, diagnose by the intersection of skin and thin needle; If CT checks and shows tumour that can be excised or not finds tumour, the mirror (though has not employed extensively) in the feasible supersound In order to carry on tumour by stages or seek and visit the little tumour that CT can't be found. Other commonly used methods are the pancreas radiography of driving in the wrong direction under supersound and inner mirror. MRI is not more accurate than CT. Artery radiography (used mainly for confirming the possibility of the operation) Tested with the pancreas function fewly and employed. Under a few situations, need to cut open the belly to ascertain.
Prognosis and treating
Total the survival rate of 5 years ' 2%. If tumour is limited to the pancreas head (less than or equal to 2cm) This rarely seen on 10% patient, implement pancreas excise skill or the intersection of Whipple and surgery (pancreas duodenum excise the skill) all ,There can be 15%~20% survival rate of 5 years. Can improve survival rate to treat to shine auxiliarily to employ 5 - FU and exterior light beam behind surgery. To the operation, auxiliary 5- FU and adds the patient who uses radiotherapy, survival rate reached 40% its 2. Find tumour that can't excise and have stomach duodenum or obstructive existence or possible of bile duct such as the operation, implement the stomach and operation of a pair of bypass of bile duct. , it is relatively high to put it into the relieving rate of jaundice of the bile duct under the mirror in adopting. Or in the the intersection of operation and dangerous high patient in 1~2 month in short-lived expectancy, put Stent mould and is superior to the surgical bypass operation under the mirror in adopting. However, 6~7 months if to life expectancy, even if the patient that the operation can't be excised, still consider the surgical bypass operation, because Stent fixed mould is blocked with the duodenum or repeated biliary tract and later period complication.
Have not revealed that use medicine singly or jointly treat and can lengthen or improve life quality. The medicine has been 5 - FU that the ones that have already been tried out used separately, purine of first ammonia butterfly, actinomycetes plain D, A is mould and plain, the card does not manage the spit of fland, the department does not manage assisting the star in spit of fland and chain. Have already been included FAM (5 - FU, A is mould and plain and mitomycin C) by the union treatment trying out ,FAMMC (5 - FU, A mould and plain, mitomycin C and department does not manage the spit of fland) And SMF (chain assists the star, mitomycin and 5 - FU) . Radiotherapy is compared with using separately, 5 - FU and radiotherapy (4500~5000cGy) Treat to some tumour patient that does not been excised jointly,be be can improve by survival ratedded. New preparation (such as gemcitabine) Perhaps more effective than the chemotherapy method based on 5 - FU. Patient that can excise to some tumour, the electronic light beam shines (4500~5500cGy) in the skill Or 125I plants into(120~210cGy) Can limit the progress of tumour somely, but relatively can not improve survival rate to shine with the other light beam. Should for the jointly treating of medicine and radiotherapy to some patient who can't excise tumour of great majority; Can only for drug therapy to shift a patient to the liver.
Most pancreas cancer patients will go through and pain and die finally. So the treatment is as important as controlling disease to the ill, should offer these patients appropriate approaching one's end care (see section 294) .
For control slight pain, aspirin 0.65g or may effective (control on pain to the intersection of acetyl and amino phenol, see the painful control of section 119) . Middle may be added with taking orally opium and lighten to severe pain. To chronic pain, long-efficiency preparation (if taking orally morphine; Injected the fragrant Buddhist nun) very much by the cover The result is the best. Close and can produce the obvious result in most patients by the cover or abdominal cavity's nerve of operation viscera. To the unable patient who tolerate pain, the skin is left, the vein, offering opium can relieve pain outside the hard membrane or in the sheath. If the palliative operation can't be lightened and continued pruritus of the hair at the obstructive jaundice, can use and subdue amine of gallbladder (oral 4g, or 4 times) 1 times a day . Phenobarbital (daily 2~4mg/kg, divides into dosage 3~4 times, limit in the range of 10~40 g/ml, in case that excessively lull) Helpful too sometimes.
Person who secrete the intersection of pancreas and function should use the intersection of pig and the intersection of pancreas and the intersection of enzyme and every the intersection of meal and 6~8 while being complete, take 2 slices while just having a dinner to the outside, take 2 slices while having a dinner to finish, the rest are taken during having meal. Should guard and control diabetes carefully.
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