???? ?????

???? ?????
Pancreatic cancer
	????? CT ?????? ????? ????? ???? ?????
????	??????????
????? ??????	????
???????	??? ??? , ???????? , ???? ???? ????? , ???? , Trousseau's syndrome
?????	????? ; sunitinib ; sucrosofate ; α-streptozocin ; doxorubicin hydrochloride ; ????????????? ; irinotecan ; ?????????? ; ??????? ; ???????? ; ?????????? ;
??????? ?????? ????
eMedicine	article/280605
DiseasesDB	9510
MeSH	D010190
MedlinePlus	000236
OMIM	260350
???????
ICD-10	C 25
ICD-11	2C10

???? ????? ??? ????? ????? ???? ????? ? ???? . ?????? ?????, ???? ????? ??? ???? ????? ?????? ???? ???????? ????????. ???????? ????? ????? ?????? ?? ?????? ??? ??????, ????, ????? ???? ???? ???? ???? ????? ??? ?????. ????? ???? ???? ????? ?????? ??????? ????? ????? ????? ????? ?????? ???? ???? 45.

?????? ???????? [ ????? ??? ???? | ????? ]

????? ????? [ ????? ??? ???? | ????? ]

????? ????? ?? ???? ????? ??? ??? ????? ? ?????? ????? ???? ???????? ?? ??? ??????? ????. ??????? ?????? ?????? ???? -???, ????? ??????, ????? ???? ??????? ? ???? ??????? ??? ?????. ??? ?? ?? ??? ??? ?????? ??????? ?? ???? ?????? ??????? ?? ????? ???-?????????. ?? ???????? ???? ?????? ????? ?? ??????? ?????. ???, ????? ???? ???? ????? ???? ?????? ?????? ???? ????? ?????????.

???? ?????? ???? ?????? ?????, ????? ??? ????? ?? ????? ???? , ????? ????? ??? ??? ?????. ?????? ??? ????? (???? 60% ?? 70% ?? ??????) ????? ????? ?? ???? ????? ????. ???? ??? ? ???????? , ?????? ???? ?? 3 ?"? ??????, ????? ?? ?????? ??? ?????? ?????? ??????? ?????.

????? ????? [ ????? ??? ???? | ????? ]

????? ????? ??????? ????? ????? ??????:

????? ????.
????? ????? ???
???? ?????? ????? ( ??????????? )
????? ???????? ????? ???? - ?????????? ??????, ??????? multiple endocrine neoplasia type 1 syndrome MEN1, ??????? ?? ?? ????' , ??????? ??? ???? ?????? ????.

????? ????? ??? ??? ????? ??????? , ????? ????? ? ??? , ?????-??? , ????? ???????? ?????? ????? ???????, ????? ??? ? ???????? ?? ???? ??? .

????? (Screening) [ ????? ??? ???? | ????? ]

??? ????? ????? ??? ????? ??? ?????? ?? ????? ???? ?? ??? ??????????. ? ?????? CA 19-9 ?-CEA ????? ??????? ?????? ?????? ?? ????? ??? ???? ????? (Sensitivity) ????????? (Specificity) ????????. ????? ??? ?????? ????? ????? ???? ???? ?? ???? ???? ?????????? (????: ????? ?? ????? ?? ???? ????? ????? ????? ?????? ?????? ????? ?????, ??????? ????? ?????? ??????? ???????? ???????? ?FAMMM, ???' ????? ??????? ???????? ???? ????? ????????) ??????? ? ????? ?????? ????? ????????? (EUS) ???????. ?????? ????? ????????? ??? ???? ?????? ??? ???? ????? ??? ???? ???? ????? ?????? ?? ???? ?????. ?????? ?? ???? ????? ??????? ????? ?????? ????????? ?????? ?? ???????? ?? ??? ???. ??????? ??? ?? ??????? ?? ??? ????? ?? ???? ?????? ^[1].

?????? ????? ?????? ?? ???? ????? ?? microRNA ????? ???? ???? ????? ?????, ?? ???? ??? ???? ?? ???? ?????? ?? ????? ?????? ????. microRNA ??? ????? ????? ??? ?????? ?? RNA ?????? ??? ?????? ????? ???????? ????? ?? ??? ??????? ?? ???? ??????'??? ????? ????? ????, ?????? (Expression) ?? ???????? ???? ??? ???????? ????. ?????? ?????? ?? ??????? ??? ?????? ???? ????? ??? ?? ???? ???? ????? ????? ??????? ????? ???? ?????? ?? ???? ????? ?????. ^[2]

????? [ ????? ??? ???? | ????? ]

?????? ????? ????? ?????? ????? ?????? ?????? ????? ????? , ?????? ??????, ???? ??????. ??? ?? ?? ??? ??? ?????? ??????? ?? ??????? ????? ???????? ?? ????? ???-?????????. ??? ?? ???? ???? ??????? ??? ??? ???? ????? ????? (????? ?"? ????????- ????? ?????? ???? ??????? ???? ?????? ?? ??? ???? ??????????? ????? ????? ?????, ??? ?????? ???? ????? ?????? ??? ???? ????? ?????? ???? ????).

????? ??????? ????? ?????? ???? ????? ????? ???? ?? ???? ?????- ??? ?????, ????? ???? ??????? ????, ??? ???? ?????? ?????? ?? ????????, ?? ???? ?????? ?????? ?????? ?????????. ???? ???? ??? ?????? ?????- Trousseau's syndrome, ?????? ?????????????? ????? (???? ?????? ?????, ??? ????? ??????? ?????) ?????? ??????? ????????? ????? ???? ?? ???????? ???.

???? ????? ?????? ???? ??? ????? ????? ?????? ?? ???????? ??????? ????. ?????? ?????? ?????? ??? ?????? ?????? ?? ?????? ?????? ? ????? ???? (????? ????? ? ????????? , y-glutamyl transpeptidase ?- alkaline phosphatase). ??? ?????? Ca 19.9 (carbohydrate antigen 19.9)‎ ????? ???? ?????? ????? ???? ?????. ???? ????, ???? CA 19-9 ??? ?????? ?????? ?????? ??? ????? ?? ???? ?????? ??????? ??? ?? ???? ???? ?????? ????? ?? ??? ???? ??. ?? ???, ???? ?????? ?? CA 19-9 ??? ?? ???? ?????? ?? CEA ?? ???????????? ??? ?????? ??? ?????? ??????? ??? ????????.

?????? ?????, ???? ?????? ????? ?? ????? ? ????????? ??????? - CT, ?????? ????? ????? ??????. ???????????? ???? ????? ??? ????? ?????, ????? ???? ??? ???? ??? ????? ?? ??????. ?????? CT ???? ????? ??? ????????, ?? ?????? ?? ???????. ?????? ????? ????????? ??? ???? ?????? ???? ????? ????? ??????? ?????? ??????? ????? ????? ????? ??????.

??????? ????? ?????? ???? ??? ????? ???????? ??????? ?????? ????? ????. ???????? ????? ????? ??????? ?????? CT ?? ???????????, ?? ?? ??? EUS. ?? ???, ????? ?????? ???? ????? ??? ??????? ?? ????? ???? ?????? ????? ????? ?? ??? ????? ??????? ?????? ????????- ??? ???? ????? ?? ?????? ???????? ????? ????? ?????? ?? ?? ????? ?? ?????? (false negative)- ????? ??????? ?????? ?? ??? ???? ?????? ??????? ????? ?? ?????? ????, ???? ???? ?????? ?????? ?? ????? ?????? ?? ????????.

????? [ ????? ??? ???? | ????? ]

?????? ????? ???? ????? ????? ????? ???? ??????. ??????? ?? ??? ??????? ???? ? ???????? ??????? ???? ????? ?????? ????? ?????? ?????? ????? ??? ???? ??????? ????? ????? ??? ??? ?????. ???? ????? (Whipple procedure) ??? ?????? ?????? ????? ???????? ??????? ???? ?????. ??? ???? ??? ?????? ????? ????? ????? ?????? ???????? ????? ‎5-fluorouracil ( 5-FU )‎ ????. ???, ?? ?????? ?- gemcitabine. ?- gemcitabine ?? ???? ?? ????? ?? ??? 5‎-FU, ?????? ???????? ?? ????? ????? ?????. ???? ???? ????? ???????? ???????? (FDA) ???? ?? ?????? ??????? ?? ???? ????? ???? ????? ?? ???? ????? ???????? ??? ????? ???????? ?????? ??, ?? ??? ????? ?-5‎-FU.

???? ???? ? ??????? ?????????? ?????? ??????? ?? ???????? ????? ???? ????? ? ????? ????? ????? ??????? ??????? ????? ??? ?? ????? ?????? ?????? ?????? ?????? ?????. ???? ??????? ????????? ???? ????? ??? ??? ???? ?????, ????? ??????? ? ???????????? ???? ????? ???? ???? ?????? ??????? ????? ?????? ?????? ?????? ???, ???? ????????? ??????.

???????? [ ????? ??? ???? | ????? ]

?????? ????????? ????? ????? ????? ???? ??? ???????? ????? ????? ?????? ??????? ???? ?????? ??????? ?? ??????? ???? ?????? ?? ???? ????? ?????? ??????? ????? ????. ????? ??????? ?????? ????? ???? ????? ???? ???? ??????, ??? 9 ?????? ^[3].

??????? ???? ??? ???? ???? ?????? ????? ?-5%. ??? ??? ???????? ? ????? ????? ?-32 ??? ???? ???? ????? ????? ???? ??? ?? ????? ?????? ?? ?????, ???? ?????? ??????? ????? ????? ?-99%, ????? ?????? ?? ???? ????? ????? ?????? ??????? ?????. ???? ????? ????? ????? ?? ???? ????? ?????? ^[^{???? ????
]} ?????? ????? ??? ????? ??????? ??? ???? .

???? ????? ???? ????? ? ????? . ????? ????? ????? ?????? ? ???????? ????? ??? ?????? ??????? ?? ????? ?? ????? ?????? ???????? ???? ?????.

????? [ ????? ??? ???? | ????? ]

????? ?????? ?????? ????? ????? ??? ??????? ?????? ?????? ?????. ????? ??????? ??? ???? ?????? ???????? ????? ????? ???? ??????. ????? ?? ???? ??? ???? ? ?????? ?????? , ?????? ????? ?? ??. ????? ?????? ????? ????? ?? ????? , ????? , ??????? ??????? ????? ???????? ?????? ?????? ???. ?????? ??????????? ??????? ???? ?? ????? ?????? ???? ?????? ?? ?????? ????? ?????.

?????? [ ????? ??? ???? | ????? ]

?????? ??? ???? ??????? ????? ????? ? ????? ????? .
???? ????? ????? ????? ?????? ?????? ??? ????.
????? ?????? ???????? ???? ????? National Cancer Institute ????? 52.7 ?????? ???? ????? ????? ???? ????? ???? 2004. ??? ???? ???? ???? ?? ?????? ????? ?? ????? ????? ???.
????? ????? ????? ???? ????? ?????? ????? ??? ????? ????? ???? ???? ????? ???????, ???? ????? ?????? ?????.

??????? ???????? [ ????? ??? ???? | ????? ]

???? ?????? ????? ???? ????? ? ??????????

???? " ???? ????? - Pancreatic cancer ", ???? ?????????
????? ?????? ????? ???? ????? ???? ??????
???? ?? ???? ????? ???? ?????? ?????? ?????
????' ??? ???????, ?????? ?? ????????? ?????? ????? ????? ?? ????? ????? , ???? ????????, 8 ?????? 2016
????? ???????: ???? ???? ??? ????? ???? ????? ?????? ???? ???? ?????? , ???? " ????? ", 5 ?????? 2018
???? ???? ????? , ???? ?? ??????? ???? ?? ???? ?????? , ???? ???? , 20 ???????? 2019
???? ????? , ?????? ???? ?? ?????? ??????? ??????? ?? ???? ????? , ???? ???? , 22 ???? 2023
??? ?????, ? ????? ????? ??? ???? ????? , ???? ?? ???? ??????? ?????? ???? ‏, 21 ??????? 2023
topic/familial-pancreatic-cancer ???? ????? , ???? ??????????? ???????? (???????)

????? ?????? [ ????? ??? ???? | ????? ]

^ Dan L. Longo, M., Dennis L. Kasper, M., J. Larry Jameson, M. P., Anthony S. Fauci, M., Stephen L. Hauser, M., & Joseph Loscalzo, M. P. (2012). In Harrison's™, PRINCIPLES OF INTERNAL MEDICINE (p. Chapter 93). The McGraw-Hill Companies, Inc.
^ Donald, J. (2014). Will detection of MicroRNA Biomarkers in blood improve the diagnosis and survival of patients with pancreatic cancer? JAMA,311, 363-365.
^ Doctors - ???? ????? - ????? ????? ????? , ???? Doctors

?????: ????? ?????????? ???? ?????? ???? ? ???? ????? ????? ????? .

[1] Dan L. Longo, M., Dennis L. Kasper, M., J. Larry Jameson, M. P., Anthony S. Fauci, M., Stephen L. Hauser, M., & Joseph Loscalzo, M. P. (2012). In Harrison's™, PRINCIPLES OF INTERNAL MEDICINE (p. Chapter 93). The McGraw-Hill Companies, Inc.

[2] Donald, J. (2014). Will detection of MicroRNA Biomarkers in blood improve the diagnosis and survival of patients with pancreatic cancer? JAMA,311, 363-365.

[3] Doctors - ???? ????? - ????? ????? ????? , ???? Doctors

[1]

[2]

[3]