Should pancreas imaging be recommanded in patients over 50 years when diabetes is discovered because of acute symptoms?
Should pancreas imaging be recommanded in patients over 50 years when diabetes is discovered because of acute symptoms?
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DOI：
10.1016/s1262-3636(07)70111-8
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发表时间：
2004-04-01
影响因子：
7.2
通讯作者：
Bauduceau, B
中科院分区：
文献类型：
--
作者：
Damiano, J;Bordier, L;Bauduceau, B
糖尿病和胰腺癌之间的关系是复杂的，不完全了解。然而，人们普遍认为，50岁以上患者新发糖尿病是胰腺癌的典型指征。但法国没有官方指令要求在这种情况下进行常规扫描。我们研究了115例年龄在50岁以上的新发糖尿病住院患者（少于30天），其不稳定性需要胰岛素治疗。常规影像学检查发现14例腹部疾病，其中6例（5.2%）为胰腺癌。除了异常严重的厌食症外，没有临床指征或实验室检查提示所发现的疾病。因此，我们对所有50岁以上新发糖尿病患者进行常规胰腺扫描，最好是MRI扫描，即使没有癌症的临床或实验室指征。这是检测小胰腺癌的唯一方法，从而为成功治疗提供了最大的希望。不幸的是，这种方法往往只能检测到已经发育良好的肿瘤。但是，在今天，临床团队无法想象在如此严重的疾病未被诊断的情况下让患者出院。
The relationship between diabetes mellitus and cancer of the pancreas is complex and incompletely understood. Nevertheless, it is generally agreed that new-onset diabetes in a patient over 50 years old is a classical indication of pancreatic cancer. But there is no official directive in France that a scan should routinely be performed in such cases. We have studied 115 patients aged over 50 who were hospitalized for new-onset diabetes (fewer than 30 days) whose instability required insulin treatment. Routine imaging revealed abdominal disorders in 14 patients, 6 (5.2%) of whom were suffering from pancreatic adenocarcinomas. No clinical indication or laboratory test, apart from an unusually severe anorexia, suggested the discovered disorders.We therefore routinely carry out a pancreas scan, preferably by MRI, on all patients over 50 years old presenting with new-onset diabetes, even if there are not clinical or laboratory indications of cancer. This is the only way in which small pancreatic cancers can be detected, thus providing the best hopes for successful treatment. Unfortunately, too often, this approach also detects only tumors that are already well developed. However, nowadays, it is not conceivable for a clinical team to discharge a patient from hospital with such a serious disease undiagnosed.