臨牀消化器内科 Vol.21 No.13(1)


特集名 膵癌早期診断のストラテジー
題名 膵癌の疫学
発刊年月 2006年 12月
著者 砂村 眞琴 帝京大学医学部外科/Cancer Surgery Section, Hammersmith Hospital, Imperial College, London, UK
著者 江川 新一 東北大学大学院医学系研究科消化器外科
著者 高田 忠敬 帝京大学医学部外科
【 要旨 】 膵癌の危険因子としてエビデンスが報告されたのは,家族歴 (膵癌,遺伝性膵癌症候群),合併疾患 (糖尿病,慢性膵炎,遺伝性膵炎),嗜好 (喫煙) である.80 %の症例がStage IVであり,未だ早期診断には大きなハードルがある膵癌では,早期発見のためには無症状の危険因子群を検診することが望ましいが,上記の危険因子を一つでも有する対象数は膨大であり,また検診での検出率がきわめて低いというのが現実である.したがって,現時点では,複数の危険因子を有する症例では膵癌発症も念頭においた慎重な経過観察と定期的検査が望まれる.日本膵臓学会膵癌登録の症例解析によれば,2001年以降の生存曲線が改善しており,ゲムシタビンの効果と推察される.
Theme Diagnostic Strategy of Pancreatic Carcinoma in Early Stage
Title Epidemiology of Pancreatic Cancer
Author Makoto Sunamura Department of Surgery, Teikyo University School of Medicine / Cancer Surgery Section, Hammersmith Hospital, Imperial College, London, UK
Author Shinichi Egawa Department of Gastroenterological Surgery, Tohoku University Graduate School of Medicine
Author Tadahiro Takada Department of Surgery, Teikyo University School of Medicine
[ Summary ] Risk factors for pancreatic cancer were analyzed in order to determine early stages of the disease. A familial history of pancreatic cancer and hereditary pancreatic cancer, the accompanying diseases of diabetes mellitus, chronic pancreatitis and hereditary pancreatitis, as well as smoking have previously been recognized as being risk factors. Since about 80 % the pancreatic of the cancer cases are determined to be Stage IV, it is difficult to provide a diagnosis during the early stages of this disease. Therefore, it is necessary to establish a routine health examination for patients who suffer from associated diseases. The data from the pancreatic cancer registry of the Japan Pancreas Society indicates that the survival rate since 2001 has improved dramatically. It is speculated that the approved use of Gemcitabine has played an important role in producing this favorable result.
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