How to check pancreatic cancer?

1. Physical examination method of pancreatic cancer: The purpose of physical examination is to check whether there is jaundice and left supraclavicular lymph node metastasis visible to the naked eye, and to check some related symptoms, such as hepatomegaly, gallbladder enlargement and upper abdominal mass. 2. Examination methods of pancreatic cancer Laboratory examination: 1) General laboratory examination: Due to obstruction of the lower biliary tract, the serum bilirubin of patients with pancreatic head cancer can be significantly increased, mainly the direct bilirubin content, while others such as serum amylase and fasting blood glucose are not specific. 2) Special laboratory examination: In recent years, efforts have been made at home and abroad to find specific antigen substances of pancreatic cancer, such as carcinoembryonic antigen (CEA), pancreatic embryonic antigen (POA), pancreatic cancer-associated antigen (PCAA), CA 19-9, pancreatic cancer-specific antigen (PaA) and leukocyte adhesion inhibition test (LAIT), among which CA19. At present, all kinds of antigens used in clinic have a certain positive rate for pancreatic cancer, but they are not specific and can only be used for clinical reference. Four pancreatic cancer markers, CA 19-9, CA242, CA724 and CA 125, were identified by the Pancreatic Cancer Clinic of Huashan Hospital, and it was found that they can significantly improve the sensitivity and specificity of pancreatic cancer diagnosis. Combined with B-ultrasound and CT, it can be used as a screening test for pancreatic cancer. 3. Imaging examination of pancreatic cancer: 1) B-ultrasound: it is the first choice for patients with suspected pancreatic cancer. This method can detect biliary dilatation and pancreatic duct dilatation at an early stage. It is possible to find tumors with a diameter greater than 1cm, and it is more likely to find tumors with a diameter of 2cm. The advantages of this method are not only safety, non-invasive and convenient, but also repeated follow-up. For patients in high-risk age groups who have symptoms such as epigastric discomfort, unexplained weight loss and anorexia, this method can be used for screening. When suspicious and uncertain, further CT examination can be done. 2) CT: CT can also be used as the first choice for patients with suspected pancreatic cancer. Its diagnostic accuracy is higher than that of B-ultrasound, and the diagnostic accuracy can reach more than 80%. The X-ray dose received is very small, which is a safe method. Pancreaticobiliary duct dilatation and tumors with a diameter greater than 65438±0cm in any part of the pancreas can be found, and retroperitoneal lymph node metastasis and intrahepatic metastasis can be found, which is helpful to judge whether the tumors can be resected before operation. Because of these advantages, although the examination is expensive, it is still the first choice for doctors. In recent years, Huashan Hospital has applied spiral CT to the diagnosis and preoperative staging of pancreatic cancer with high accuracy. Through the three-dimensional imaging reconstruction method, a clear image with three-dimensional and 360-degree rotation can be obtained, thus improving the reliability of preoperative staging diagnosis. 3) Magnetic resonance imaging: pancreatic tumors larger than 2cm can be found, but the overall image detection effect is not better than ct. Magnetic resonance angiography (MRA) combined with three-dimensional imaging reconstruction method can provide a clear image rotated 360 degrees, which can replace angiography. MRCP (magnetic resonance cholangiopancreatography) can partially replace ERCP (endoscopic retrograde cholangiopancreatography), which is helpful to find pancreatic head cancer. 4) X-ray examination: Duodenal barium meal hypotonic radiography can find the image of duodenal invasion and progress of pancreatic head cancer. Selective celiac arteriography (DSA) has certain diagnostic value for pancreatic cancer. The sensitivity and accuracy of ERCP in the diagnosis of pancreatic cancer can reach 95%. Because it is a traumatic examination, it is only used when B-ultrasound and CT can't diagnose it. Through ERCP, pancreatic juice can be collected or cells can be brushed for examination. Positron emission tomography (PET) has a high detection rate of pancreatic cancer, but the examination cost is expensive. 5) Radionuclide pancreatic imaging: As a pancreatic imaging agent, 75Se- methionine has certain diagnostic value for large pancreatic cancer. 4. Other examination methods for pancreatic cancer: 1) Pancreatoscopy: With the continuous development of endoscopic technology, pancreatoscopy has entered clinical application in recent years. It can directly enter the lumen of pancreatic duct for observation, collect pancreatic juice and exfoliated cells for analysis, and detect K-ras gene.