【摘要】 目的 上腹痛是胰腺癌患者的主要表现之一，但极少数患者可能以其他部位腹痛为主诉。本文通过分析2例 以左下腹痛为主诉的胰腺癌患者的临床特征，目的在于提高胰腺癌的诊断水准。 方法 以蛋白质芯片技术检测CA19-9等 肿瘤标记，B超检查胰腺等上腹部脏器，螺旋CT胰腺薄层扫描，以及进行内镜下逆行胰胆管X线造影（ERCP）等。发现胰腺 占位之后，患者转至外科行剖腹探查，采取胰腺病灶和转移结节标本，做病理学组织检查。 结果 以左下腹痛为主诉的2例 胰腺癌患者CA19-9显著增高;B超和CT显示胰腺体、尾部占位，肝内多发转移灶以及后腹膜淋巴结肿大;手术证实胰腺体、 尾部肿瘤浸润，腹膜、肝脏、肝十二指肠韧带、肠系膜根部、盆腔等处见多个大小不等的结节。术后病理报告为腺癌。 结论 极少数胰腺体、尾部癌患者可能以左下腹痛为主要临床表现。因此，在注意胰腺癌的典型表现的同时，也应加强对那些腹部 症状不典型，但有胰腺癌发病易感因素的患者的警惕性，运用有效的检查方法，实现胰腺癌的早期诊断和早期治疗。
【关键词】 胰腺癌;诊断
Pancreatic cancer predominated by pain in the left lower quadrum of the ab- domen
CHEN Mei-mei，CHEN Guang-yu，DONG Guo-fang，et al.
Department of Gastroenterology，Xinhua Hospital， Shanghai Second Medical University，Shanghai 200092，China
【Abstract】 Objective Epigastric pain is one of the major clinical manifestations of the patient with pancreat- ic cancer，but very occationally some cases may come to consultation with chief complaint of pain in other abdom- inal areas.The author analysed the clinical features of 2 cases with pancreatic cancer predominated by pain in the left lower quardrum of the abdomen，in order to promote the diagosis of the disease. Methods CA19-9，to- gether with other tumor markers，was determined with protein arrays.B-mode ultrasonography and high-speed spiral computed tomography （CT） were employed for detection of pancreas and other abdominal organs.Endo- scopic retrograde chologiopancreatography （ERCP） was also used as well.When confirmed to have occupied pancreatic lesions， they were transfered to surgical department for abdominal exploration and samples of the pan- creatic tumor，along with
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