| In many developed and some developing countries the incidence of pancreatic cancer(PC) has increased since the fifties of the twentieth century. At present,it ranks in the preceding ten cancers of human body in some countries.Because of the difficulties to diagnose PC early,the poor effects of chemical therapy or surgical therapy and its poor five-survival rate(<5%),peopl always endeavor to seek for approaches to diagnose PC early from mutation gene and tumor marker tests. however,as for PC's several clinical features,such as its initial and main symptoms,factors which affect these symptoms,its misdiagnosis and detection rates by imaging tests ,there are no agreements with them in the scholars.It is no doubt that these clinical features will benefit PC's diagnosis and treatment early.The objective of this study is to try hard to discern these features.Employing clinical epidemiological methods,we designed a piece of detailed and accurate questionnaire,collected 1027 PC cases clinical data,by means of face-to-face inquiry,interview or correspondence,telephone,then classified them respectively.All data were imported into computer for statistical analysis,thus sum up PC's and its several special types' clinicopathologic features. We selected some none-PC cases as control group when we quantified and scored a certain symptom.The results showed that,1)the mean age of PC cases was 59.3 years-old,70% PC cases had their tumors in the head of pancreas,17% were in stage â… when diagnosed,84.6% were adenocarcinomas,the overall resection rate was 27.9%(in the supreme hospitals) and the overall one-year survival rate was 29.4%; 2)abdominal pain,jaundices and epigastric discomfort were the most initial symptoms, abdominal pain,jaundices,weight loss and anorexia were the most main symptoms;there was no significance in the differences of early abdominal pain scores between PC cases andnon-PC cases;the case's age and tumor location dramatically affected his clinical symptoms,and the blood type affected in some degree; 3) the misdiagnosis rate of PC approximated to 60%; diseases of misdiagnosis were belong to 50 categories,in which the most common diseases were gastritis and duodenitis,peptic ulcer,virus hepatitis,cholelithiasis and chronic pancreatitis; the misdiagnosis dramatically affected patient's tumor resection rate and five-year survival rate; 4) ultrasonography and computed tomography had satisfactory detection rates to PC; to determine PC's tumor size,ultrasonography was approximate to pathologic-histology, and endoscopic ultrasonography was the optimal test to detect small PC; 5) the serum carbohydrate antigen 19-9 was valuable to diagnose and assess the prognosis of PC cases; 6) as for small PC cases,jaundices were the initial and main symptoms,in which 75% were painless jaundices; 52.8% cases were in stage â… when diagnosed,the overall resection rate was 86.1%,and the overall one-year survival rate was 64%; 7) as for cystadenocarcinoma cases,abdominal pain were the initial and main symptoms, jaundices were the unusual symptoms; about 1/3 cases were in stage â… when diagnosed,the overall resection rate was 42.3%,and the overall one-year survival rate was 51.2%; 8) the second primary PC accounted for about 3% of total PC,of which about 50% occured after breast cancers and gastric cancers; their clinical symptoms were approximate to general PC,but their diagnoses were so late that only 3% cases were belong to stage â… when diagnosed, and the overall one-year survival rate was 25%; 9) the giant cell carcinoma of pancreas also had some clinical features different from the general PC.Therefore we concluded that though the clinical symptoms of PC cases are atypical in general,still there have some cues in them; to pay attention to medical history, to recognize initial symptoms of PC and its several special types will benefit its early diagnosis; making great effort to identify PC early,especially small PC,prevent misdiagnosis are critical to progress its prognosis; the demand of diagnosis should be consi...
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