Disease Overview
pancreaticcarcinomaisonetype发lifeinpancreaticexternalsecretionglandularofmalignant tumor，due toitsearly-stagesymptomsnotsignificant、high degree of malignancy、prognosisPoor,known as"carcinomainof王"。incidencerankingmalignant tumorNo.7position(males)andNo.11position(females)，accounting formalignant tumorrelateddeathrateNo.6position。itsinpancreas头carcinomamostcommon(approximately70%)，pancreasbody尾carcinomarelativelyrare。due topancreaticpositiondeepin，tumorearly-stagenoteasyfound，confirmed diagnosistimemoreasadvanced-stage，5yearsurvival rateonlyapproximately10%-15%。
Major Causes
Genetic factors：approximately10%patients具havefamilial hereditary，BRCA1/2、PALB2etc.gene突changeincreasing患diseaserisk。
chronicpancreaticInflammation:especiallygenetictypepancreatic炎andFamilytypepancreatic炎patients，malignant transformation risksignificantelevated。
Diabetes：new发Diabetes(particularly>50years old)cancanispancreaticcarcinomaearly-stagesignPhenomenon.
Smoking：Smokingenablingpancreaticcarcinomaincidence riskelevated2-3times，is唯onebright确ofenvironmentalrisk factor。
High-fat diet：long-termhighfat、highprotein、lowFiber intakefoodincreasingrisk。
Alcohol consumption：long-termextensiveAlcohol consumptionandchronicpancreatic炎andcarcinomachangerelated。
Obesity：BMI>30kg/㎡thoseincreased risk。
Occupational exposure：long-termExposure tocertain(萘amine, Biphenylamineetc.)。
Common Symptoms
early-stagesymptoms：
upperabdominaldiscomfortorDull pain:easyandstomachintestine疾diseaseConfused with
food欲decreaseretreat、digestiveadverse、steatorrhea
unexplainedemaciation
progressive-stagesymptoms：
persistentSevereabdominal pain：radiationRadiating to the lower backregion, At nightaddheavy, Curled uppositioncandecreaselight
obstructive jaundice：skin, Scleral icterus,small便deepJaundice, clay-colored stools
body weightRapidlyunderdecrease：advanced-stage呈cachexiaconditionstate
血sugardifferentnormal：new发Diabetesor原haveDiabetesaddheavy
ascites, Abdomen:advanced-stagepatientscan触andupperabdominalmass
metastasissymptoms：
bone pain(bonemetastasis)
cough、hemoptysis(pulmonarymetastasis)
hepaticenlargement、jaundiceaddheavy(hepaticmetastasis)
Classification and Staging
Pathological Classification
ductal adenocarcinoma(accounting for90%and above)：high degree of malignancy，prognosis差
acinar cell carcinoma：relativelyrare，multiplelifeinyearlightpatients
mucinous cystadenocarcinoma: Related toforrelatively low degree of malignancy
neuroendocrine tumors：includinginsulinoma、gastrinomaetc.，regionclassified into恶type
othertype：catheterinternalPapillacondition黏fluidcarcinoma(IPMN)、solidtypefalsePapillaconditiontumoretc.
TNM Staging(AJCC8th edition)
Primary Tumor (T)
Tis：Carcinoma in situ
T1：Tumor confined topancreaticinternal，maximum diameter≤2cm
T2：Tumor confined topancreaticinternal，maximum diameter>2cmbut≤4cm
T3：Tumor invadespancreaticexternal，butNot involvingandceliac axisandsuperior mesenteric artery
T4：Tumor invadesceliac axisorsuperior mesenteric artery(notcanresection)
Regional Lymph Nodes (N)
N0：No regional lymph node metastasis
N1：1-3lymph nodesmetastasis
N2：≥4lymph nodesmetastasis
Distant Metastasis (M)
M0：No distant metastasis
M1：Distant metastasis present
Clinical Stage Grouping
Ⅰstage：T1N0M0
Ⅱstage：T2N0M0，T1N1M0，T2N1M0
Ⅲstage：T3N0M0，T3N1M0，T3N2M0
Ⅳstage：anyTN0-2M1，T4anyNM0
Diagnosis
Tumor markers：CA19-9(mostnormalusing，sensitivetypeapproximately70%-80%)，CEA、CA125canelevated。
Imaging studies：
contrast-enhanced CT：preferredassessmentmodality，showtumorposition、size、vascularinvasion
pancreaticMRI/MRCP：moreclear晰showbiliary tractobstruction
PET-CT：usingintestingdistantmetastasis
endoscopic ultrasound(EUS)：assessmentcanresectiontypeandguidancepuncture biopsy
pathological biopsy: PercutaneousorEUSguidanceunderpuncture，bright确Diagnosis
preciseinterventional therapypancreaticcarcinoma，minimally invasivetechnologyaspatientsIlluminatehope
interventional therapypancreaticcarcinoma，isinadvancedofimagingequipment(such asDSA、CT、ultrasound)guidanceunder，willFine and slenderofcatheterorpunctureneedlepreciseDelivered topancreatictumorregionpositionorasitsBlood supplyofvascular，performedlocaltreatment：
1. arterial infusion chemotherapy：willhigh浓degreechemotherapydrugdirectlyinjectedtumoroffeeding artery，allowingdruginitsinternalregionpersistentexerteffect，localdrug浓degreemorehigh，morecanachievedrugSustained release,effectmoreLong-lasting.
2. radioactive seedsimplantation： willsuch asRice grain-sizedsizeofradioactive seeds(碘-125)Permanenttypeimplantationtumorinternalregion，throughpersistentReleaselow剂amountraysClose-rangeleavedestroytumorcells，forsurroundingnormal tissuedamage极small。
3. stent implantation： needlefortumorcompressionbile ductcausingofjaundice，orcompressionduodenalcausingofobstruction，canimplantationbiliary tractstentorintestine道stent，fastRapid resolutionexceptobstruction，improvementpatientsquality of life，asposterior续treatmentCreate conditions.
interventional therapypancreaticcarcinomaofoutstandingAdvantages:
1. trauma微small：typicallyonly需oneneedleeyesizeof伤mouth。
precision strike：drugorenergydirectlyeffectintumor，systemicside effectssignificantreduce。
2. recoveryrapidly： patientstypicallypostoperatively1-2天namelycanunderClinical activitymove。
3.适usingextentBroad: Suitable forusinginnomethodsurgical resectionoflocaladvanced-stage、recurrenceormetastaticpancreaticcarcinomapatients，alsocanandsurgery, Radiotherapychemotherapycombinedenablingusing。
4.effectivereliefsymptoms：such asfast速decreaselightjaundice、painetc.，significantimprovementpatientssurvivalamount。
interventional therapyinpancreaticcarcinomaofcomprehensivetreatmentbody系inPlays a rolemoretomoreimportantof角color, Especiallyitsforlosetosurgeryopportunityofpatients，interventional therapycaneffectivecontrollocaltumor、reliefsymptoms, Extendinglongsurvivalstage，andcancanaspartialpatientsCreating opportunities for conversionsurgeryofopportunity。it绝non-‘nothave办methodof办method’,whileisafter充minuteverifyof, Departmenteffectiveoftreatmentchoice。foradvanced-stagepancreaticcarcinomapatientswhileSpeaking,interventional therapyofsignificance远notstopin延longsurvivalstage。
Prevention and Follow-up
regularlybodyExamination:high-riskpopulationrecommended50years of ageevery 1-2 yearsproceedpancreaticultrasoundorCTexamination
control血sugar：new发DiabetespatientsRequires ruling outpancreaticcarcinoma
healthy diet：reduceRed meat,addProcessed meatintake，increasing膳foodFiber
regularmotor：weeklyat least150minute钟inetc.strongdegreemotor
quit smoking and limit alcohol：effectivereduceincidence risk
follow-up：postoperativelyfirst 2 yearsevery 3 monthsfollow-up examination，years 3-5every 6 monthsonce，after 5 yearsannuallyonce