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Pancreatic cancer

Последний просмотренный: 22 Aug 2025
Last updated: 02 Sep 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • jaundice
  • nonspecific upper abdominal pain or discomfort
  • weight loss and anorexia
  • back pain
Полная информация

Другие диагностические факторы

  • age 65-74 years
  • steatorrhea
  • thirst, polyuria, nocturia, and weight loss
  • nausea, vomiting, and early satiety
  • unexplained acute pancreatitis
  • hepatomegaly
  • epigastric abdominal mass
  • positive Courvoisier sign
  • petechiae, purpura, bruising
  • Trousseau sign (migratory thrombophlebitis)
Полная информация

Факторы риска

  • smoking
  • family history of pancreatic cancer
  • other hereditary cancer syndromes
  • chronic sporadic pancreatitis
  • diabetes mellitus
  • obesity
  • dietary factors
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • pancreatic protocol CT
  • abdominal ultrasound
  • LFTs
Полная информация

Исследования, проведение которых нужно рассмотреть

  • prothrombin time (PT)
  • CBC
  • cancer antigen (CA)19-9 biomarker
  • positron emission tomography
  • endoscopic retrograde cholangiopancreatography (ERCP)
  • MRI
  • magnetic resonance cholangiopancreatography
  • endoscopic ultrasound
  • staging laparoscopy (with laparoscopic ultrasound)
  • biopsy
Полная информация

Неотложные исследования

  • genomic testing

Алгоритм лечения

Острый

resectable (stages 1 and 2)

locally advanced unresectable (stage 3)

metastatic (stage 4)

Составители

Авторы

Hemant M. Kocher, MBBS, MS, MD, FRCS

Professor of Liver and Pancreas Surgery

Barts Cancer Institute

Barts and The London School of Medicine and Dentistry

London

UK

Раскрытие информации

HMK is an author of a number of references cited in this topic. HMK has received research grants from Bristol-Myers-Squibb (formerly Celgene) for investigator-initiated clinical trials. HMK has unrestricted educational grants from Meril, Mylan, Medtronics, and Ethicon.

Выражение благодарностей

Dr Hemant M. Kocher wishes to gratefully acknowledge Dr Fieke E.M. Froeling, a previous contributor to this topic.

Раскрытие информации

FEMF is an author of a reference cited in this topic.

Рецензенты

Ross Carter, FRCS

Consultant Pancreatic Surgeon

West of Scotland Pancreatic Unit

Glasgow Royal Infirmary

Glasgow

UK

Раскрытие информации

Not disclosed.

Nikhil I. Khushalani, MD

Assistant Professor of Oncology

Roswell Park Cancer Institute

Buffalo

NY

Раскрытие информации

NIK has received funding for the conduction of clinical trials and associated translational studies from Merck, Pfizer, and Astra-Zeneca. NIK has a grant from the National Comprehensive Cancer Network (from research support by Roche).

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma [internet publication].Полный текст

Conroy T, Pfeiffer P, Vilgrain V, et al. Pancreatic cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2023 Nov;34(11):987-1002.Полный текст  Аннотация

Sohal DPS, Kennedy EB, Cinar P, et al. Metastatic pancreatic cancer: ASCO guideline update. J Clin Oncol. 2020 Aug 5:JCO2001364.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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