[Progress of preoperative diagnosis of pancreatic tumor--with special reference to extension of pancreatic cancer].
Preoperative diagnosis of the extension of pancreatic cancer is very important for determining the range of resection. We evaluated the preoperative imaging diagnosis of the tumors and compared it with the pathological diagnosis. Out of 68 pancreatic head cancers, the percentage of correct diagnosis of serosal invasion was 69.1%, that of over-estimate was 23.5% and that of under-estimate was 7.4%. In the case of retroperitoneal invasion, a correct diagnosis had been made in 79.1%, over-estimate in 4.5% and under-estimate in 16.4%. In the case of portal vein invasion, these percentages were 52.8%, 39.6% and 7.5%, respectively. In the case of lymph node involvement, these percentages were 85.3%, 2.9% and 11.8%, respectively. The percentage of preoperative over-estimate was higher for serosal invasion and that of preoperative under-estimate was higher for retroperitoneal invasion. In the case of portal vein invasion, the percentage of preoperative over-estimate was relatively high. Of the 12 patients who had paraortic lymph node metastases, 6 patients had a single metastatic node in the paraortic area. The minimum size of these nodes was 2 x 2 mm. Only 5 cases could be diagnosed preoperatively. We evaluated the usefulness of abdominal CT scan and superior mesenteric arteriography for the diagnosis of superior mesenteric arterial wall invasion. In both methods, the over-estimate rate was 0%, but the under-estimate rate was relatively high. Conclusively the preoperative diagnosis of the extension of the pancreatic cancer by conventional imaging methods has some limits.
Ueno
K
K
Department of Surgery II, School of Medicine, Kanazawa University.
Tuchihara
K
K
Yoshimitu
Y
Y
Suzaki
Y
Y
Takeda
T
T
Mori
K
K
Kobayashi
H
H
Kayahara
M
M
Ohta
T
T
Nagakawa
T
T
D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*