In recent years, pancreatic cancer has consistently ranked first in the 5-year survival rate list for malignant tumors with a low survival rate. One of the reasons is that it is difficult to find. If it is not for related imaging and tumor marker examinations, it is difficult to diagnose at an early stage. “Of the patients with pancreatic cancer found in outpatient clinics, 80% are in the advanced stage.” said Li Dewei, director of the Department of Hepatobiliary and Pancreatic Oncology, Chongqing University Affiliated Tumor Hospital. “There are no specific symptoms in the early stage of pancreatic cancer, only mild abdominal distension and abdominal pain, more than 60% Patients are easily misdiagnosed as gastric disease, chronic cholecystitis, etc., thus delaying the best treatment opportunity. Therefore, we must have a clear understanding of pancreatic cancer, and should not focus on treatment, but on prevention. ”
Frequent “rubbing” at the end of the year, the pancreas will suffer
Christmas carnival, have a meal! Celebrate the new year, have a meal! A bonus is given at the end of the year, and a meal… At the end of the year, with the increase of banquets and gatherings, the number of acute and severe patients with digestive system diseases such as alcoholism, acute cholecystitis, acute gastritis, acute pancreatitis and so on in major hospitals is increasing. .
Director Li Dewei said, “After alcoholism and overeating, food and alcohol will stimulate the pancreas to secrete large amounts of pancreatic juice. If the pancreatic juice is too late to be secreted into the duodenum, or the duct to the duodenum is blocked, the pancreas in the pancreas Enzymes are activated prematurely in the pancreas, and so-called pancreatic “self-digestion” will occur, which will cause acute pancreatitis. After removing the predisposing factors, most patients will heal quickly, but a small number of patients suffer from acute pancreatitis. Pancreatic tumors compress or block the pancreatic ducts. In the acute phase of pancreatitis, pancreatic inflammation and edema will cover the pancreatic tumors, making ordinary CT or B-ultrasounds unable to effectively detect tumors.” Therefore, Director Li Dewei reminded Patients who have no clear predisposing factors for pancreatitis, especially middle-aged and elderly people, who often have “stomach discomfort or pain”, the tumor marker CA19-9, or the recent increase in blood sugar, need to be after the recovery of acute pancreatitis Do more detailed examinations as soon as possible to detect pancreatic tumors early. In addition, it should be noted that if acute pancreatitis is not thoroughly treated, it will turn into chronic pancreatitis, and the risk of pancreatic cancer in patients with chronic pancreatitis will be significantly increased.
The incidence of pancreatic cancer has been increasing year by year, especially in women
According to the latest tumor incidence data, the incidence of pancreatic cancer is 5 to 6 per 100,000, which is not high compared to high incidence cancers such as lung cancer and liver cancer. However, pancreatic cancer is on the rise, and the incidence has risen to the 10th place among malignant tumors.
In the past, the incidence of pancreatic cancer in men was much higher than that in women, and most of them were middle-aged and elderly people aged 50 to 70. However, a recent study jointly published by the Chinese University of Hong Kong, Peking University and the University of Melbourne showed that the incidence of pancreatic cancer is showing a younger trend, especially in the female population. Director Li Dewei analyzed that this may be related to the fact that bad lifestyles such as irregular work and rest, less exercise, and preference for high-fat, high-calorie and high-sugar foods are more common among young people, and the increasing harm of secondhand smoke and alcohol to women.
In addition, recent survey reports have found that the incidence of pancreatic cancer in diabetic people is significantly higher than that in the general population. Director Li Dewei pointed out: Long-term (especially more than 5 years) diabetes is a moderate risk factor for pancreatic cancer; diabetes can be an early manifestation of pancreatic cancer. Clinically, 40% of pancreatic cancer patients have diabetes at the time of diagnosis.
The pancreas is hidden and there are few symptoms
The pancreas lies deep in the abdominal cavity and is the second largest digestive gland in the human body. It has dual functions of internal and external secretion. Endocrine function mainly refers to the secretion of insulin, glucagon, somatostatin, etc., which participate in the body’s growth regulation, material metabolism and blood sugar regulation. The exocrine function is realized by the joint production of pancreatic juice from the pancreatic acinar and ductal system. Pancreatic juice contains a large number of digestive enzymes and alkaline liquids, which play a leading role in the digestion of food. Therefore, once the pancreas has a problem, it is often manifested as digestive dysfunction, especially upper abdominal discomfort. Most people will not pay attention to it, or delay the best treatment time due to the treatment of stomach diseases.
Therefore, Director Li Dewei reminded that when there is abdominal distension, diarrhea, indigestion, nausea, upper abdominal discomfort, vomiting, jaundice, unexplained blood sugar fluctuations and weight loss, etc., if gastrointestinal diseases and diabetes are excluded, one should be alert to pancreatic cancer. Possible. Examination methods mainly include endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, blood tumor marker CA19-9, CEA examination and so on. If suspicious pancreatic disease is found after the above examination, it should be checked monthly until it is ruled out or diagnosed.
Surgery is the main method, and early diagnosis and treatment are particularly important
In the treatment of pancreatic cancer, because there is no specific targeted drug at present, and the effect of radiotherapy and chemotherapy is not obvious, although the pancreas is deeply located in the peritoneum and the surgical operation is difficult, it is still the main method. Director Li Dewei introduced that laparoscopic pancreaticoduodenectomy is currently the most widely used procedure for the treatment of pancreatic cancer. It has the advantages of minimally invasive, precise, less bleeding, and quicker recovery after surgery, but it is also the most complicated at present. One of this kind of laparoscopic surgery is known as the “Everest” in the hearts of surgeons.
Pancreatic cancer easily invades important blood vessels, and laparoscopic resection and reconstruction of blood vessels can achieve the purpose of radical resection. Now, the department where Director Li Dewei works all adopt autologous vessel reconstruction + autologous vessel transplantation. Compared with artificial blood vessels, autologous blood vessel transplantation has the advantages of strong anti-infection ability, low thrombosis probability, fewer complications, and saving costs for patients.
Director Li Dewei emphasized that “early detection and early treatment” is the key to determining the survival time of patients. Therefore, people with high risk factors for pancreatic cancer should be screened regularly.
Healthy lifestyle, reduce the risk of disease
The etiology of pancreatic cancer is not yet clear. In addition to the aforementioned chronic inflammation of the pancreas and diabetes, studies at home and abroad have found that its occurrence is related to the following five factors:
1. Smoking. Smoking is currently the only high-risk factor for pancreatic cancer that can be determined. After tobacco is absorbed, inactive substances can be metabolized in the liver to become carcinogens. These substances are excreted by bile and enter the pancreas through reflux, causing ductal epithelial cancer to become cancerous after a certain period of action.
2. Long-term drinking and coffee. Both can cause increased gastrin secretion, which may induce pancreatic cancer.
3. Obesity. Studies have shown that if BMI [body mass index, calculated by dividing body weight (kg) by the square of height (m)] exceeds 30, the risk of pancreatic cancer will increase by 1.4 times for men and 1.3 times for women. Analysis believes that obese people tend to eat high-sugar, high-fat, and high-cholesterol foods. Long-term excessive intake of these foods can easily increase the load of the pancreas and cause the deterioration of pancreatic cells.
4. Environmental factors. Studies have shown that people who are exposed to heavy metals and chemicals for a long time have an increased risk of cancer.
5. Genetic factors. About 3% of pancreatic cancer patients have a family history, some patients have pancreatic cancer susceptibility genes, and family members are more likely to develop pancreatic cancer than the general population.
In short, pancreatic cancer is a lifestyle disease. Quit smoking, limit alcohol intake, control the intake of animal fat, increase the intake of fiber in the diet, enhance the protection of workers exposed to occupational exposure in the chemical industry, actively control diabetes, and maintain a healthy weight. Reduce the risk of pancreatic cancer.
