CAJ | 학술논문

胰腺癌常指起源于胰腺外分泌系统导管上皮的导管腺癌，这是因为它占全部胰腺恶性肿瘤病例90％以上，它是人类致死第4位的常见癌。在致病因素中，吸烟是致使环境污染的重要原因，此外，体质指数、慢性胰腺炎、摄入高动物脂肪也是重要的危险致病因素。糖尿病和糖耐量损害也占到诊断胰腺癌病例的80％以上。但最为重要的危险因素是基因素质，胰腺癌显示了广泛的基因突变谱，胰腺癌平均具有63种突变基因，但仅有4种基因被识别，其中一种是癌基因KRAS ，3种是抑癌基因CDKN2A、SMAD4和 TP53。胰腺癌的病理变化，从大体看常为一种坚实和硬的实体病变，轮廓不清晰，很少囊变；从组织学看，多数腺体结构组成内含一种富含促结缔组织增生的基质。胰腺癌的肿瘤标记物较少，最常使用的是CA‐19‐9，是一种Lewis寡糖抗原，伴有环流的粘蛋白，已广泛在临床使用，如CA －19－9值高于1000u／ml时，常预示此肿瘤已不可切除。
이선암상지기원우이선외분비계통도관상피적도관선암，저시인위타점전부이선악성종류병례90％이상，타시인류치사제4위적상견암。재치병인소중，흡연시치사배경오염적중요원인，차외，체질지수、만성이선염、섭입고동물지방야시중요적위험치병인소。당뇨병화당내량손해야점도진단이선암병례적80％이상。단최위중요적위험인소시기인소질，이선암현시료엄범적기인돌변보，이선암평균구유63충돌변기인，단부유4충기인피식별，기중일충시암기인KRAS ，3충시억암기인CDKN2A、SMAD4화 TP53。이선암적병리변화，종대체간상위일충견실화경적실체병변，륜곽불청석，흔소낭변；종조직학간，다수선체결구조성내함일충부함촉결체조직증생적기질。이선암적종류표기물교소，최상사용적시CA‐19‐9，시일충Lewis과당항원，반유배류적점단백，이엄범재림상사용，여CA －19－9치고우1000u／ml시，상예시차종류이불가절제。
Pancreatic cancer referees to duct adenocarcinoma because more than 90% of them are of ductal epithelial origin . It is the fourth most common cause of cancer death worldwide .Cigarette smoking is the most reproducible environmental risk factor ,other include increased body mass index ,chronic pancreatitis ,high intake of animal fat ,and prolonged contact with petroleum .Diabetes or impaired glucose tolerance is observed in up to 80% of patients of pancreatic cancer .But the greatest risk factor for developing pancreatic cancer is genetic predisposition .Pancreatic cancer revealed wide spectrum of mutation ,an average of 63 somatic mutations per tumor ,but only 4 were identified frequently :1 oncogene(KRAS) and 3 tumor suppressor genes(CDKN2A ,SMAD4 ,and TP53) .There are firm and hard mass lesions that mimic primary cystic neoplasms of the pancrease . Histologically , most are composed of glandlike structures embedded in the abundant desmoplastic stromatolites .The tumor marker is limited of pancreatic cancer CA‐19‐9 ,a sialylated Lewis antigen associated with circulating mucins ,is the most widely used marker for pancreatic cancer .