Some problems of clinical, laboratorial and computer tomographical diagnosis of pancreatic cancer / Монголын Анагаах Ухаан

ABSTRACT

Introduction: There have been limited research studies done in Mongolia on clinical, laboratorial and computer tomographical diagnosis of pancreatic cancer. Goal Our study aims to examine clinical, laboratorial and CT symptoms diagnosis of cancer pancreatitis, to diagnose the differential types of cancer pancreatitis, and to develop diagnostic criteria based on CT for differentiating among those types. Objective: 1. To study clinical symptoms of pancreatic cancer 2. To conclude the correlation between CA 19-9, CEA and sizes of the tumor during pancreatic cancer 3. To determine CT symptoms of pancreatic cancer 4. To develor diagnostic criteria based on CT for differentiating among those types Material and method: Over the years of 2006 to 2010, we have studied the CT symptoms of 35 patients diagnosed as having pancreatic cancer, and the clinical and laboratorial symptoms of 35 patients with the same disease, with the help of health facilities at Diagnostic Imaging Department of the “Achtan” clinical hospital and “Friendship-Naran” diagnostic center. The scanners such as CT-W-4 type scanner of Japanese Toshiba Corporation, MSCT Presto (made in 2007 by Hitachi, Japan) and CT Max 640 type scanner of USA Gereral Electric Corporation have been used for the diagnostics. When we made the result of survey, we used average descriptions of statistics, determined the fault of descriptions and examined probability descriptions the criterion by Stiyudent. Result: The pancreatic cancer happened to exist in the head and skull for 71.6%±8.7 (P<0.001), was non-standart shaped for 62.5%±8.6 (P<0.01), had size being bigger than 2.1 cm for 96.9%±8.4 (P<0.001), had density decline for 46.9%±8.8 (P<0.05), had tumor contour not clearly visible for 65.6%±8.4 (P<0.01), had fat tissue around cancer not seen for 75.0%±7.7 (P<0.001), had an enlarged common bile duct 65.6%±8.4 (P<0.05), had an enlarged gallbladder for 59.4%±8.3 (P<0.05), and experienced a density increase after contrast injection for 65.6%±8.4 (P<0.001). Conclusion: 1. Pancreatic cancer caused shooting abdominal pain and stomach cramps in 74.2%±8.2, diarrhea in 62.9%±8.2, flatulency in 71.4%±7.6, xerostomia and xerosis in 65.7%±8.0, neurasthenia symptoms in 85.7%±5.9, jaundice in 60.0%±8.3, and abdominal hemorrhage and bleeding symptoms in 54.3%±8.4. 2. CA-19-9 tumor marker has been found to be very sensitive for pancreatic cancer, making it an effective and easy way to diagnose, prove the diagnosis, and monitor a patient’s response to pancreatic cancer treatment. CEA marker can be used as a supporting tool for pancreatic cancer. 3. CT scanning revealed that the cancer was irregularly shaped in 62.5%±8,6, was larger than 2.1 cm in 96.9%±3.1,had non-smooth borderlines in 65.6%±8.4 and clear and visible borderlines in 62.5%±8.6. Density decreased in 46.9%±8.8, fatty tissues around the cancer were not distinguishable in 75.0%±7.7, and density increase after contrast injection in 65.6%±8.4. 4. Size, shape, structure, density, borderlines, interaction of pancreatic cancer with neighboring organs, location of the cancer in pancreas, cancer’s shape, size, numbers, border, structure, density and density after contrast injection, calcification, and shadow have been proven to be the determining factors of pancreatic cancer. 5. CT diagnostics of pancreatic cancer types and differentiating among them are very crucial to select appropriate treatment for pancreatic cancer on time