摘要
Abstract
Objective To analyze the clinical characteristics and causes of misdiagnosis of pancreatic cancer as atypical pancreatitis,and to summarize the key points for differential diagnosis,in order to enhance the ability of early identification.Methods A retrospective analysis was conducted on the clinical data of 2 patients with pancreatic cancer who were misdiagnosed as having atypical pancreatitis at the Third Hospital of Shijiazhuang City from January 2015 to August 2024,including symptom manifestations,laboratory indicators,imaging examinations,pathological results,treatment processes and prognosis.Results Both patients presented with epigastric pain as the main symptom.The early symptoms were not specific,and serum amylase levels were only slightly elevated or normal.Both were diagnosed with atypical pancreatitis and received standard treatment,which proved ineffective.One patient experienced recurrent abdominal pain,weight loss,and an enhanced CT scan indicating a lesion in the pancreatic tail.A laparoscopic radical resection of the pancreatic body and tail along with splenectomy was performed.The postoperative pathology confirmed pancreatic well-differentiated ductal adenocarcinoma.The misdiagnosis lasted for 3 months.After diagnosis,adjuvant chemotherapy was given,and liver metastasis occurred at 4 months after the surgery.The other patient had long-term unrelieved abdominal pain,a serial increase in carbohydrate antigen 19-9(CA19-9),obstructive jaundice,and imaging suggesting a lesion in the pancreatic head with metastasis.A puncture biopsy confirmed pancreatic well-differentiated adenocarcinoma.The misdiagnosis lasted for 2 months.Due to the advanced stage of the disease,curative treatment was not feasible.The patient received palliative therapy and eventually died of multiple organ failure.Conclusion The early manifestations of pancreatic cancer are similar to those of atypical pancreatitis.A single tumor marker test or routine imaging is insufficient to rule out malignant lesions.For patients with recurrent epigastric pain,poor response to conventional therapy,and concomitant weight loss or a serial increase in CA19-9,timely completion of contrast-enhanced CT,endoscopic ultrasound,or positron emission tomography-computed tomography should be carried out.When necessary,a needle biopsy should be performed to reduce misdiagnosis and facilitate an early intervention.关键词
胰腺癌/误诊/不典型胰腺炎/糖类抗原19-9/增强CT/穿刺活检Key words
pancreatic cancer/misdiagnosis/atypical pancreatitis/carbohydrate antigen 19-9/contrast-enhanced CT/needle biopsy
