胰腺癌临床诊断现状的单中心调查分析

Analysis of current diagnosis situation of pancreatic cancer：experiences from a single medical center

摘要:

目的：研究胰腺癌患者从出现症状到确诊所经历的过程，分析其中的经验教训，为如何从患者和医护人员两方面共同努力提高胰腺癌的早期诊断率提供決策依据。方法：对已经确诊为胰腺癌的120例患者进行调查分析，调查内容包括最先出现的症状、就诊的科室、最初的诊断、出现症状到确诊的时间、是否接受手术治疗及手术方式等内容。结果：患者从出现症状到确诊平均耗时12周。80%的患者初始症状为上腹部不适﹑腹痛﹑腹胀﹑消化不良等非特异性表现，患者就诊往往首先选择消化内科﹑中医科（中西医结合科）等，约1/3的患者最初被诊断为胃炎/胃病/胃脘痛。仅有不到20％的患者首次就诊时得到确诊。结论：胰腺癌患者早期症状没有特异性，漏诊﹑误诊率高，确诊时往往已是晚期。消化内科、中医科（中西医结合科）医护人员提高对胰腺癌的警惕性以及普及有关胰腺癌的基本知识对提高胰腺癌的早期诊断、改善胰腺癌预后至关重要。

Abstract:

Objective：To investigate the experiences of patients with pancreatic cancer from initial symptom occurring to confirmed di－agnosis and to provide strategies for early diagnosis of pancreatic cancer through the effort from both doctors and patients. Methods：Data of 120 patients with pancreatic cancer were analyzed including initial symptom，initial department visited，initial diagnosis，time from initial symptom occurring to confirmed diagnosis，accepting surgery or not and surgery methods，etc. Results：Average time from initial symptom occurring to confirmed diagnosis was 12 weeks. Upper abdominal discomfort，abdominal pain，abdominal distention and indigestion were the first symptoms in 80% patients. Most patients firstly went to see doctors in the department of digestive or Chinese traditional medicine. About one third of patients got the initial diagnosis of gastritis/gastropathy/epigastric pain. Only less than 20% got the correct diagnosis on the first visit. Conclusions：Patients with pancreatic cancer do not exhibit any specific symptoms on the illness onset，thus with a high rate of misdiagnosis and missed diagnosis. Educating doctors in the department of digestive and Chinese traditional medicine and patients with basic knowledge of pancreatic cancer plays a very important role in getting earlier di－agnosis and better prognosis of these patients.