| Abstract | Tumori gušterače mogu biti benigni i maligni. Karcinom pankreasa je zloćudni tumor gušterače koji potječe iz egzokrinog dijela gušterače. Iz različitih Langerhansovih stanica potiču endokrini tumori poput gastrinoma, inzulinoma, vipoma, glukagonoma ili somatostatinoma. Karcinom gušterače jest najčešća zloćudna novotvorina egzokrinog dijela gušterače. Procjenjuje se da je kod nas karcinom pankreasa treći maligni tumor probavnoga sustava po učestalosti dok je po uzroku smrtnosti na četvrtom mjestu. Više od dvije trećine su adenokarcinomi. Karcinom gušterače dvostruko se češće javlja u muškoj populaciji nego u ženskoj. Incidencija prosječno iznosi 7 na 100 000 ljudi godišnje. Karcinom najčešće nastaje u glavi gušterače, u čak 60% slučajeva. Dok se u ostalim slučajevima javlja: 15% u trupu, 5% u repu, a u 15 do 20% bolesnika tumor zahvaća cijelu gušteraču. Etiologija nije još posve poznata, ali se češće javlja u osoba oboljelih od kroničnog pankreatitisa te se 2 do 3 puta češće javlja u pušača. Pojava određenih simptoma izravno ovisi o lokalizaciji tumora. U ranoj fazi bolesti tegobe su neodređenoga karaktera. Kada bolesnik dolazi liječniku zbog određenih tegoba najčešće je bolest već u uznapredovanoj fazi. Najčešće se javljaju zbog mukle boli, koja se obično javlja u gornjem dijelu trbuha, odnosno u epigastriju sa širenjem boli u leđa. Ikterus nastaje uslijed opstrukcije ductus choledochusa tumorom u području glave gušterače. Uz žuticu se javlja svrbež, tamni urin te aholična stolica. Od simptoma se mogu još javiti gubitak tjelesne težine, anoreksija, umor, mučnina i povraćanje. Nažalost, zbog kasnog otkrivanja bolesti, u 80% bolesnika tumor je inoperabilan te se kod njih koristi palijativno liječenje. U bolesnika kod kojih je moguća operacija radi se radikalni operativni zahvat kao jedino moguće izlječenje. Nakon operacije slijedi terapija zračenjem te kemoterapija. Prognoza bolesti je loša. Većina bolesnika umire unutar 12 mjeseci, a samo mali broj preživi 5 godina nakon radikalne operacije. |
| Abstract (english) | Pancreatic tumors can be benign or malignant. Pancreatic cancer is a malignant tumor of the pancreas originating from the exocrine part of the pancreas while endocrine tumors such as gastrinoma, insulinoma, vipoma, glucagonoma, or somatostatinoma originating from different Langerhans cells are usually considered as a separate entity. Pancreatic cancer is the most common malignant neoplasm of the exocrine pancreas. It is estimated that pancreatic cancer is the third most common malignant tumor of the digestive system and the fourth most common cause of death from malignant neoplasms. More than two-thirds are adenocarcinomas. Pancreatic cancer is twice as common in men as in women. The incidence averages 10/ 100,000 people per year. Approximately 60% of cancers develop in the head, 15% in the trunk, 5% in the tail, and in 15 to 20% of patients the tumor affects the entire pancreas. The etiology is not yet fully known, but it is more common in people with chronic pancreatitis and 2 to 3 times more common in smokers. The appearance of certain symptoms directly depends on the localization of the tumor. In the early stages of the disease, the problems are of an indeterminate nature. When a patient comes to the doctor because of certain ailments, the disease is usually already in an advanced stage. They most often occur due to dull pain, which usually occurs in the upper abdomen, respecting in the epigastrium with the spread of back pain. Icterus occurs due to obstruction of the ductus choledochus by a tumor in the area of the head of the pancreas. Jaundice is accompanied by itching, dark urine and aholic stools. Symptoms may include weight loss, anorexia, fatigue, nausea, and vomiting. Unfortunately, due to the late detection of the disease, in 80% of patients the tumor is inoperable and they use palliative treatment. In patients in whom surgery is possible, radical surgery is performed as the only possible cure. The operation is followed by radiation therapy and chemotherapy. The prognosis of the disease is poor. Most patients die within 12 months, and only a small number survive 5 years after radical surgery. |
