Pancreatic Cancer Diagnosis

Pancreatic cancer is a malignant tumor originating from the pancreatic ductal epithelium, with a higher incidence in middle-aged and elderly individuals. Due to the hidden location of the pancreas and atypical early symptoms, many patients are already in the middle or late stages at diagnosis. Without timely detection and intervention, cancer cells can quickly invade adjacent organs or metastasize distantly, severely affecting prognosis. Currently, diagnosis is mainly based on a combination of imaging, tumor markers, histopathology, and genetic testing.

Diagnostic Basis

1. Signs and Clinical Evaluation
Early pancreatic cancer often lacks obvious symptoms. As the tumor grows, patients may experience persistent abdominal pain, jaundice, weight loss, and loss of appetite. Tumors located in the pancreatic head may cause bile duct obstruction, resulting in yellowing of the skin and sclera. Clinicians must be alert to these nonspecific symptoms and combine them with personal and family medical history as initial screening clues.

2. Serum Tumor Marker Testing
CA19-9 is currently the most commonly used tumor marker for pancreatic cancer. Although its specificity and sensitivity are limited, it has high reference value for disease monitoring and efficacy evaluation. CEA (carcinoembryonic antigen) may also be elevated. It is important to note that CA19-9 can also be abnormally elevated in benign diseases such as cholangitis and gallstones, and thus cannot be used alone for diagnosis.

3. Ultrasound, CT, and MRI Imaging
Abdominal ultrasound is a preliminary screening method used to evaluate bile duct dilation or large masses. Contrast-enhanced CT is important for assessing pancreatic structure, tumor extent, and metastasis. MRI has better soft tissue resolution than CT, especially MRCP technology, which is more valuable for pancreaticobiliary lesions. Combining the two can improve diagnostic accuracy.

4. Endoscopic Ultrasound (EUS) + Fine Needle Aspiration Biopsy
EUS provides close-up observation of pancreatic lesions and guides fine-needle aspiration biopsy (EUS-FNA) to obtain cell or tissue samples for pathological diagnosis. This technique has high resolution and low invasiveness and is widely used for patients who cannot obtain tissue samples through other means.

5. PET-CT for Systemic Lesions
In some patients, PET-CT can detect small metastatic lesions, aiding clinical staging and treatment planning. It assesses tumor activity and extent by detecting glucose metabolism. It is useful for preoperative evaluation or treatment follow-up but is not the first-line screening tool for pancreatic cancer.

6. Histopathology and Molecular Diagnosis
Tumor tissue analysis using HE staining and immunohistochemistry confirms adenocarcinoma type, differentiation degree, and biological characteristics. In recent years, genetic testing (such as KRAS and TP53 mutations) has further clarified tumor progression mechanisms, with some mutations closely related to targeted or immunotherapy efficacy.

7. Multidisciplinary Team (MDT) Consultation
Once pancreatic cancer is diagnosed, a multidisciplinary team including surgical oncology, radiation oncology, radiology, internal medicine, and immunotherapy specialists should evaluate the case to determine whether surgery, radiochemotherapy, or immune reconstruction cell therapy is appropriate, providing patients with individualized treatment pathways.

Conclusion

Experts at United Life International Medical Center remind us that diagnosing pancreatic cancer requires high vigilance and multidisciplinary collaboration. Once suspicious symptoms such as upper abdominal discomfort or jaundice appear, patients should promptly undergo standardized evaluation. The integration of high-resolution imaging, pathological biopsy, and immune cell-based methods facilitates early diagnosis and precise treatment, securing valuable time and treatment opportunities for patients.