What inspections should pancreas cancer be done? 's symptom

What inspections should pancreas cancer be done? 's symptom
First, image learn to check
1. check Ultrasonography B for diagnosing the methods first-selected of pancreas cancer and while checking by screening method in general survey should notice whether acoustic measurement pancreas thicknesses heads ultra last 30mm pancreas head big or small (the ultrasonic value of very beginning of male pancreas of the overwhelming majority is less than 30mm women and less than 28mm) ,Pancreas the intersection of body and thickness greater than 25mm person ' Normal men are smaller than 22mm women and smaller than 20mm) In the liver and/or outside the liver) Expand gallbladder cyst large shifting cooking stove the intersection of pancreas and the intersection of cancer and positive rate about to 3cm can reach in the liver
2.Ultrasonic inspection of the fibrous gastroscope Construct and find early pathological change
3. check CT scan and can last the position sizes correct of pancreas tumour CT and and not can if you can't find diameter about tumours of 1cm, be can if you can't strengthen, scanned with around a vascular relation or Make some tie sweep intangible focus afford to reveal The profit was judged CT has already at present diagnosed the rate of accuracy of pancreas cancer can be reached as main methods CT to diagnose pancreas cancer for operation way and prognosis
4.Magnetic resonance imaging (MRI) Can reveal pancreas outline unusual to can judge whom early part infringe shift to judge the intersection of pancreas and cancer, especially confine low pancreas in the pancreas to according to the intersection of T1 and the intersection of signal and level that weighting look like Cancer and have pancreas spread week, and blood vessel infringe the intersection of respect and MRI superior to CT it scans to be the intersection of pancreas and the intersection of cancer and better method that predict in front of the operation
5.Drive in the wrong direction cholangiography of pancreas (ERCP) under the inner mirror Have shape that can also observe clearly besides revealing main pancreatic ducts are narrow to full of defect and stop up the pancreatic duct is narrow of higher specificities that changes and can be examined to the diagnosis of pancreas cancer Find pancreatic duct pathological change that tumour is smaller than 2cm is the effective method to diagnose little pancreas cancer
6.Alternative angiography (SAG) SAG whether one damage check but can make diagnosis can reveal shape of artery around the pancreas to judge tumour have blood vessel infringe important meaning if artery at the intersection of tumour and 1cm Abnormality narrow to hard to get and can infer size of tumour can judge the intersection of tumour and possibility of operation and choose the intersection of operation and way judge according to the intersection of SAG and finding also according to unusual the intersection of blood vessel and area It is to blockade arteries to soak and select the rate of accuracy for use when usually images can't be diagnosed clearly while studying the result and is higher than whether the disconnected operation could excise a very important one
7.The sub mother's pancreatic duct mirror is checked A new method of his sub mirrors that develop and launch recently ' Pancreatic duct mirror) Diameter needn't competent the intersection of duodenum and papilla it cuts skills to be by the intersection of mother and mirror for 1mm only ' Fibrous duodenum mirror) It insert at pancreatic duct observe directly and in charge of inside information condition is mucous membrane grand to hard to get waiting for ultraly ruddily narrowly but it has that pipe diameter is getting more detailed too to it is apt that if you can't roll over, decrease front can't change direction mirror still at present at the time of cancer in pancreas Can't fetch and examine but may become the main means to diagnose pancreas cancer after several years alive
Second, tumour mark thing
Find Koprowski,etc. since 1979 and digestive tract tumour CA19-9s antigenics relevant because development of clone technologies single find at present after obtaining development that be advanced by leaps and bounds Correlated to pancreas cancer the intersection of tumour and the intersection of mark and thing have 10 the intersection of multi-type and clinical having CA50Span-1Dupan-2POACEA wait for, use many reagents at home at present besides CA19-9 commonly used Expensive most hospital yet can popularize but tumour detection of mark diagnose postoperative recur and that shift monitoring to screening, pancreas of cancer and pancreas good and malignant and swollen for import Differentiation of tumour of great importance like check, can raise his positive rate with two or more of tumour mark thing
1. is CA19-9 for pancreas the antigen theirs relevants of cancer express to last lewis blood group the expression lewis the checking to last pancreas to CA19-9s negative too of CA19-9s negatives of the antigens The intersection of sensitiveness and specificity, gland of cancer and accuracy 83.1% or 73% 75% little patient of pancreas cancer level of CA19-9 the intersection of higher primary school and the intersection of gland and cancer in 2cm positive rate only 60.7% but The intersection of patient and level of CA19-9 that have older tumours Gaoyang rate more than 80% the intersection of boundary and value determine 120kU/L as higher than value person this suspect the intersection of pancreas and cancer can also judge in advance at the same time highly relatively CA19-9 drop normal the intersection of value and the intersection of serum and critical value to if tumour recur, shift and condition it worsens can see CA19-9 to be obvious once again for the intersection of 30kU/L person and better prognosis after back tumour excise Raise so CA19-9 is the effective mark thing of pancreas cancer
2. is CA50 that lewis the one of antigen and CA19-9ses of system needn't more have these two antigens determined if united CA50 and CA242 together at the same time for finer relevance too Measuring can improve the sensitiveness diagnosed to pancreas cancer
3. patient of gland cancer of Span-1 can up to 1 446KU/L their sensitivenesses of to 81% specificity to 68% but last the tumour rates positives of 2cm pancreas the diagnoses of cancers little unsatisfactorily Only
4. Dupan-2 its in critical value 400KU/L is and CA19-9 be can make masculine gender not led and raised 95% gallbladder to last shadow of liver functioned to be jointly detected of 50%- 70% for the sensitiveness of pancreas cancer Closely related with with GOT loudly
Mark tumour, write thing, can't launch specific and on the low side to early cancer and little the intersection of pancreas and cancer ( lt extensively still while being these above-mentioned; Tumour of 2cm) Positive to lead low to exist a certain one to be false and positive with to react, employ to screen high-risk group, pancreas of cancer and judge prognosis recur, have accumulating certain jointly alternately other tumour still Act on very much
5 CEA (the embryo antigen of cancer) Positive 78.9% rate to low to split up of gland cancer gt; 3cm tumour and last bed than positive extensions obvious can used for lasting prognosis after lasting CEA life cycles on average negative for 38.6 month obviously to the pancreases of the issues cancer rates positive
Third, cancer gene are measured
1. genetic in Yas pancreas cancer C-Ki-ras gene 12 password at frequencies high the points of son break through but changes C-Ki-ras 12 significants such pancreas diseases other Password son have very much high incidence spend PCR in the intersection of pancreas and cancer ' The nuclear acid mixes and polymerase response) Complement, hybridize with widowed nucleotide or the intersection of PCR and product measure pancreas organize the intersection of C-Ki-ras and the intersection of cancer and the intersection of gene and 12 some mutation, son of password, might become the intersection of pancreas and cancer diagnose until that of differential diagnosis reliable Molecular biology means have report 18 have the intersection of gene and 12 the intersection of password and the intersection of mutation and positive rate of son this and foreign countries been compatible for 94.7% in 19 the intersection of pancreas and cancer that make a definite diagnosis of already (12 are positive up to 100%) But not pancreas cancer case ( For instance insulinogenic tumour and pot belly cancer and gastric carcinoma and gallbladder cancer,etc. amount to 17) The detection that it is this negative kind of gene mutation can be used for diagnosing pancreas cancer and differential diagnosis in early days
2. express is rates positive high and not relating to tumour size and prognosis C-erbB-2 gene this products genetic on pancreas
3. it is high in expressing rate on pancreas cancer in the genes since last cancer P21,have no specificity, be obvious diagnosis value, is differentiation of malignant tumours good against pancreas meaningfulled
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