Wie viel Diagnostik ist beim Pankreaskarzinom nötig?

Zusammenfassung

Es werden die zz. gegebenen Möglichkeiten erörtert und bewertet, um zu einer früheren Diagnose beim Pankreaskarzinom, einer besseren Differenzierung zur segmentalen Pankreatitis und zu anderen Pankreastumoren zu kommen sowie ein Staging zu erreichen, das unnötige Operationen einschränkt. Als mögliche relevante anamnestische Hinweise, die an das Vorliegen eines PCa denken lassen, werden sonst nicht abklärbare Oberbauchbeschwerden, besonders im Zusammenhang mit einem pathologischen oralen Glukosetoleranztest bzw. dem Neuauftreten eines Diabetes mellitus und/oder erhöhte Pankreasenzymen, genannt. Der Endosonographie im Zusammenhang mit gezielter Biopsie wird sowohl bei der Diagnostik des PCa als auch seiner Abgrenzung zur chronischen Pankreatitis ein vorderer Platz eingeräumt. Bei selbst intraoperativ unmöglicher Abgrenzung des PCa von einer segmentalen chronischen Pankreatitis wird die intraoperative fächerförmige Feinnadelbiopsie empfohlen.

Abstract

The possibilities which actually exist in order to obtain an earlier diagnosis in pancreatic carcinoma, a better differentation of massforming pancreatitis and of other pancreatic tumors and an improved staging for reducing unnecessary operations are presented and evaluated. Possible relevant hints of the history and indicators for diagnostic procedures in view of a pancreatic carcinoma are upper abdominal complaints especially in relation to a new developed diabetes mellitus and/or unexplained elevations of pancreatic enzymes. The endosonography in combination with a target biopsy is of important value as well for the diagnosis of pancreatic cancer as for differentation against a segmental chronic pancreatitis. In cases where differentation is impossible even intraoperatively, we recommend the use of intraoperative fine needle biopsy.

Pankreaskarzinom - Frühdiagnostik - Differenzialdiagnose - segmentale Pankreatitis - Staging

Pancreatic cancer - early diagnosis - differentation to mass forming pancreatitis - staging

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