TAILIEUCHUNG - Chapter 089. Pancreatic Cancer (Part 3)

Carcinoma of the pancreas. A. Sonogram showing pancreatic carcinoma (P), dilated intrahepatic bile ducts (d), dilated portal vein (pv), and inferior vena cava (IVC). B. Computed tomography scan showing pancreatic carcinoma (dark arrows). C. Endoscopic retrograde showing abrupt c utoff of the duct of Wirsung (arrow). D. Magnetic resonance cholangiopancreatography showing obstruction (Obs) in the pancreatic duct (PD). The gallbladder (GB), hepatic duct (HD), and common bile duct (CBD) are labeled. Tissue Diagnosis and Cytology Patients with disease that is potentially curable by surgery, and in whom a highly suspicious lesion is seen on imaging, are often taken directly to. | Chapter 089. Pancreatic Cancer Part 3 Carcinoma of the pancreas. A. Sonogram showing pancreatic carcinoma P dilated intrahepatic bile ducts d dilated portal vein pv and inferior vena cava IVC . B. Computed tomography scan showing pancreatic carcinoma dark arrows . C. Endoscopic retrograde showing abrupt c utoff of the duct of Wirsung arrow . D. Magnetic resonance cholangiopancreatography showing obstruction Obs in the pancreatic duct PD . The gallbladder GB hepatic duct HD and common bile duct CBD are labeled. Tissue Diagnosis and Cytology Patients with disease that is potentially curable by surgery and in whom a highly suspicious lesion is seen on imaging are often taken directly to surgery without prior tissue confirmation of cancer. This is because of theoretical concerns that a percutaneous fine-needle aspiration may result in dissemination of cancer intraperitoneally or along the track of the biopsy needle. In addition negative cytology may not be sufficient evidence to avoid surgery particularly with small lesions. EUS-guided fine-needle aspiration is increasingly being used even in patients with potentially resectable disease as there is less risk of intraperitoneal spread of cancer. Other methods of obtaining specimens for cytological analysis include sampling of pancreatic juices or brushings of ductal lesions obtained by ERCP. Serum Markers The most widely used serum marker in pancreatic cancer is cancer-associated antigen 19-9 CA 19-9 . It has a reported sensitivity and specificity of about 80-90 and is suggestive rather than confirmatory of the diagnosis of pancreatic cancer. Serum levels of CA 19-9 can be elevated in patients with jaundice without pancreatic cancer present. The level of CA 19-9 may have prognostic implications with very high levels sometimes found in patients with inoperable disease. In advanced disease patients treated with chemotherapy who had high pretreatment levels of CA 19-9 have also been found to have a worse survival whereas .

• Y học thường thức
• Pancreatic Cancer
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu y khoa
• Harrisons Internal Medicine
• BMC Cancer
• Pancreatic carcinoma
• Pancreatic exocrine insufficiency
• Unresectable pancreatic cancer
• Pancreatic enzyme replacement therapy
• Recurrent pancreatic ductal adenocarcinoma
• Recurrent pancreatic cancer
• Metastatic pancreatic cancer
• Gemcitabine nab paclitaxel
• Combination chemotherapy
• Pancreatic ductal adenocarcinoma
• Neoadjuvant chemotherapy
• Perioperative chemotherapy
• Randomized trial
• Pancreatic stellate cells
• Extracellular matrix
• PSC CM induced chemoresistance
• Overall survival
• Pancreatic intraepithelial neoplasia
• Cancer stem cells
• Tumor stroma
• Tumor microenvironment
• Recurrence pattern
• Pancreatic neoplasm
• Pancreatic juice
• Mutation analysis
• Liquid biopsy
• Elderly patient
• Non surgical treatment
• Charlson comorbidity index
• Physical activity
• Life course
• Pancreatic cancer risk
• Life course physical activity
• Differential diagnosis
• Pancreatic head cancer
• Distal cholangiocarcinoma
• Histopathological similarity
• Liver metastases
• Unexpected liver metastasis
• Peritoneal carcinomatosis
• Advanced disease
• Lethal cancers
• Cancer incidence
• Locally advanced pancreatic cancer
• Induction chemotherapy
• Salvage therapy
• Prognostic factor
• Borderline resectable pancreatic cancer
• Neoadjuvant chemoradiotherapy
• Progression of vascular invasion
• Confidence interval
• Cancer stem cell
• Protein kinase C
• Nab paclitaxel
• Lymphoid cell types
• Tumor growth
• Human clinical treatment
• Neoadjuvant therapy
• Anatomically widely spread
• Intensity modulated radiation therapy
• Advanced cancer
• Biliary tract cancer
• Lung cancer
• Multimodal intervention
• Enzyme gamma glutamyltransferase
• Serum gamma glutamyltransferase
• Tumor cell proliferation
• Tumor progression
• Human pancreatic cancer
• Severity assessment
• Animal models
• Murine model of pancreatic cancer
• Non invasive methods compared
• European surgeons
• Hormone sensitive lipase
• Adipose tissue inflammation
• Pancreatic inflammation
• Animal model
• H 1 parvovirus
• Oncolytic virotherapy
• Clinical protocol