Recently, 67-year-old Wang always felt uncomfortable in the “stomach”, gastroscopy suggests gastritis, the effect of oral gastric drugs is not obvious, and weight loss, enhanced CT examination found that there is a 4cm in diameter occupancy in the tail of the pancreatic body, and multiple foci in the liver, highly suspected of pancreatic cancer liver metastasis. According to the latest flow survey data in 2019, the incidence of pancreatic cancer in China has risen to the 10th place of malignant tumors, and the number of pancreatic cancer cases per year has exceeded 100,000, with the incidence rate in developed cities being significantly higher than that in suburban rural areas. Due to the slow increase of pancreatic cancer incidence rate and poor prognosis, experts predict that by 2030, pancreatic cancer will be second only to lung cancer in terms of the number of deaths per year. Pancreatic cancer is “grumpier” than other tumors, it is highly malignant, easy to recur and metastasize, and difficult to diagnose at an early stage, with a low surgical resection rate, insensitivity of radiotherapy, and lack of targeted drugs, which have led to poor treatment results of pancreatic cancer. Many times when pancreatic cancer patients are diagnosed, they are already in the middle or late stage, the treatment effect is poor in this period, and 50% of pancreatic cancer patients will have metastasis. Not only do they lose the chance of surgery, but they also develop liver, abdominal and lung metastases. In addition, there are 30% of patients in localized progressive stage, also losing the opportunity for surgery. In other words, only 20% of patients can really be operated. The 5-year survival rate of early pancreatic cancer after radical surgical treatment reaches 20%, with an average survival time of 2 years, while the average survival time of intermediate and advanced pancreatic cancer is only 6 months. Therefore, early diagnosis and treatment is the key!!!! However, since the pancreas is located deep in the body, hidden behind other organs such as stomach and intestines, pancreatic cancer has no obvious symptoms or signs in the early stage, which are similar to those of many other diseases, such as gastritis and gastric ulcers, thus often causing misdiagnosis. Therefore, early pancreatic cancer has hidden clinical manifestations and is good at camouflage, as if it is covered with a layer of mysterious veil, which brings abnormal difficulties in early diagnosis. How to do early diagnosis, do not miss the diagnosis of pancreatic cancer! The key is to be good at identifying the traces of early pancreatic cancer and not to be blinded by its veil. The following points we must pay attention to. 1, stomach pain, not necessarily a stomach disease Like Lao Wang, most pancreatic cancer patients begin to show irregular pain in the epigastrium, and often belching, acid reflux, fullness and other symptoms. Sometimes accompanied by poor appetite, which can be partially relieved after eating, it is often mistaken by patients as stomach disease, so that the treatment time is missed. Gastroscopy is not obvious problems, oral gastric drugs after poor results must be careful, to do enhanced CT, MRI and tumor indicators, do not be “gastric disease” veil blinded. 2, high blood sugar, not necessarily just diabetes Compared with the general population, the risk of pancreatic cancer in diabetic patients increased by two times, especially the age of more than 50 years old, new-onset diabetes and pancreatic cancer is more relevant. Pancreatic cancer is usually detected in middle-aged and older patients with new-onset diabetes within 3 years of being diagnosed with diabetes. At present, the specific pathogenesis is still unclear at present, one of the possible reasons: high blood sugar causes a series of metabolic changes, so that the pancreatic cells lack the synthesis of a certain raw material for repairing DNA, leading to KRAS mutation, and 90% of pancreatic cancer have KRAS mutation, so it can be said that high blood sugar and pancreatic cancer have a high correlation, greatly increasing the risk of pancreatic cancer. In addition, diabetic patients have immune function regulation disorders, which also predispose them to malignant tumors due to impaired immune function and weakened immune surveillance. For some older people without obesity, family history and other risk factors, a sudden rise in blood glucose or unstable blood glucose, may indicate pancreatic cancer, which is an early warning signal, we must be careful, regular checkups, don’t be “diabetes” veil blinded. 3, back pain, not necessarily orthopedic problems Pancreas in the peritoneum behind, that is, adjacent to the spine. Especially the tumor of the tail of the pancreatic body, the retroperitoneal space has a large growth space, when the pancreatic tumor grows up and invades or compresses the abdominal plexus, it will cause pain in the low back, especially the symptom of aggravation of pain when lying down, so many people will think that it is the pain caused by lumbar spondylosis and ignore it. If there is no abnormality in orthopedic examination, or the treatment effect is not good according to lumbar spondylosis, we must pay attention to the possibility of pancreatic cancer. 4, steatorrhea, not necessarily intestinal inflammation Pancreatic lesions, especially chronic pancreatitis, its digestive function will be weakened, and the vast majority of fat in the human body are digested in the pancreas, fat can not be digested directly through the fecal discharge to form steatorrhea. If a patient with chronic pancreatitis does not have abdominal pain, it is easy to be confused with gastrointestinal diseases such as enteritis. In addition, chronic pancreatitis is also a high risk factor for pancreatic cancer, which often evolves into pancreatic cancer. Therefore, long-term steatorrhea patients should pay attention to check the pancreas for problems. 5, pancreatitis, not just pancreatitis This is also a piece of the mystery of pancreatic cancer. Part of the pancreatic cancer due to tumor compression of the main pancreatic duct leading to pancreatitis attacks, after conservative treatment relief, but because the tumor is not removed, resulting in recurrent attacks of pancreatitis. In fact, this is a wake-up call for us from pancreatic cancer, the key lies in whether we have the heart to find it. For more than 60 years old, no obvious pancreatitis factors, such as gallbladder stones, hyperlipidemia, alcoholism and other pancreatitis must be careful with the possibility of pancreatic cancer, even if this time because of the lumps are small and CT and other tests have not been found, but also pay attention to the possibility of pancreatic cancer to remind the patient to regular review, some patients in the review process due to the tumor grows up after being found so that can be treated at an early stage. Jaundice, not necessarily liver dysfunction The tumor of pancreatic cancer grows in the head of pancreas, which may compress the pancreatic duct, leading to pancreatic duct dilation, and also compress the bile duct, which may lead to bile duct dilation in the light time, and in serious time, the bile duct may be completely obstructed, which triggers jaundice, which is clinically known as painless jaundice. This is one of the most common clinical manifestations of pancreatic head cancer. There are also many cases in which patients go to the department of infectious diseases because of jaundice considering only liver disease. If there is no history of hepatitis and obstructive jaundice is present, pancreatic cancer should be considered as a possibility. All in all, early diagnosis of pancreatic cancer is very important but also difficult, so we must be more careful not to be blinded by its veil.