[in Japanese]

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We analyzed 71 cases of pancreatic cancer discovered in those who had undergone a ultrasonographic (US) screening and studied the possibility of discovering life-savable pancreatic cancer. It was difficult to discover life-savable pancreatic cancer by the once- a-year US screening alone. We studied whether or not various biochemical examination are effective for screening. Urine amylase·CEA·CA 19-9 were unsuitable for screening because prognosis of the group of cases showing high levels of these compounds was poor. Fasting blood sugar and serum amylase also showed a poor screening efficiency. Prognosis of the group showing high elastase 1 levels was better than the normal level group. With its cut off value set at 300ng/dl, elastase 1 could cover most of the TS1 cases, stage 1-2 cases and cases with the survival time of 3 years or more. To conduct an elastase 1 examination for the age group in which pancreatic cancer develops by preference and a close examination for the cases showing more than 300ng/dl is considered an efficient method for discovering life-savable pancreatic cancer.

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[in Japanese]

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A mass survey for pancreatic cancer using ultrasonography (US) is still necessary for improvement. We found 753 pancreatic abnormalities (0.9%) by US in consecutive 87, 597 subjects undergoing periodical health examination in Chubu Health Care Center during 1993-2002. demonstrated 544 of dilatation of pancreatic duct (72%), 72 of pancreatic cyst (10%), 56 of pancreatic tumor (7%), 21 of pancreatic calcification (3%) and 8 of pancreas swelling (1%). Further examinations revealed various pancreatic diseases, including 11 of intraductal papillary tumors, 4 of pancreatic carcinoma, 2 of solid cystic tumor of pancreas, 1 of islet cell tumor and 1 of serous cystadenoma. In patients with pancreatic cancer, one died with hepatic metastasis after pancreatoduodenectomy, and one is surviving for 6 years after distal pancreatectomy. Two had unresectable cancer. It is difficult to detect a resectable small pancreatic cancer, because patients suffering from pancreatic cancer are older than those subjects of mass survey at present. Also, it is difficult to establish high-risk group of pancreatic cancer. Subsequent further examinations by endoscopic ultrasonography (EUS) or enhanced computed tomography (CT) may be efficient tools to find a small respectable cancer.

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