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Pancreatic cancer, the "king of all cancers," is not untreatable! With proper treatment, long-term survival can be achieved

时间：2026-04-27　人气：

Case Analysis

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Mrs. Li went to the hospital for abdominal and pelvic CT due to unbearable abdominal pain, thinking it was stomach pain. The results showed "a low-attenuation mass lesion with coarse margins is visible in the pancreatic body, measuring approximately 2.9*1.8cm. It is considered to be a possible pancreatic body cancer, with adjacent structures involved".

In May 2019, the patient underwent radical resection of pancreatic body and tail cancer. The pathological results showed moderately-to-poorly differentiated adenosquamous carcinoma, with small foci exhibiting sarcomatoid structure and focal areas accompanied by significant fibrosis. No definite intravascular thrombus or neural invasion was observed.

Immediately afterward, four cycles of adjuvant chemotherapy with gemcitabine plus temozolomide were administered. Post-chemotherapy follow-up results indicated a reduction in peritoneal and pelvic effusion compared to previous findings.

However, a follow-up MRI three months later revealed suspicious abnormal signals in the residual pancreatic parenchyma, with similar abnormal signals in the right lobe of the liver as before. Additionally, the tumor marker CEA gradually increased and exceeded the normal range.

At this point, for Mrs. Li and her family, the anxiety had not subsided, as the follow-up results indicated a gradual progression of the disease.

After contacting Professor Zhang Minghui and his team from Tsinghua University School of Medicine, an analysis of Mrs. Li's condition was conducted:

Mrs. Li's condition assessment

Pancreatic cancer is highly malignant, and the pathological types of patients are complex - "moderately-poorly differentiated", "adenosquamous carcinoma", and also have "sarcomatoid" structures, which increases the risk of subsequent recurrence and metastasis.

The patient developed postoperative ascites and peritoneal effusion, which decreased after adjuvant chemotherapy but still persisted, and should not be taken lightly.

The routine follow-up after chemotherapy indicates suspicious signals in the residual pancreas and right lobe of the liver. Considering the elevated tumor marker, the possibility of disease progression in the patient has increased.

NKT cell immunotherapy can delay the time of recurrence and metastasis, and it is currently the best time for patients to undergo treatment.

In December 2019, Mrs. Li underwent NKT cell therapy. Due to her high risk of subsequent recurrence and metastasis, an intensive regimen of two courses per month was adopted for treatment.

Now, six months later, after eight consecutive courses of systematic treatment, three follow-up visits, and imaging examinations, no clear signs of tumor recurrence have been observed, and the tumor marker CEA has returned to normal levels. This indicates that the previously high risk of recurrence and metastasis has been suppressed.

Mrs. Li reports feeling more energetic than before. At the end of her surgery, she needed assistance to walk, but now she can even ride a shared bicycle. Her appetite has also improved, and her quality of life has significantly improved, with a higher score compared to when she first joined the study.

Treatment Overview

On December 12, 2018, a patient underwent an abdominal and pelvic CT scan, which revealed a low-attenuation mass shadow in the pancreatic body with a rough margin and a size of approximately 2.9*1.8cm. The possibility of pancreatic body cancer was considered, with adjacent structures being involved.

On December 18, 2018, a pancreatic mass biopsy was performed. Pathology revealed poorly differentiated cancer infiltration.

On April 9, 2019, Normal range of tumor markers: CEA 4.28ng/ml, CA19-9 <0.6U/ml.

On May 6, 2019, under general anesthesia, laparoscopic exploration was performed, followed by open radical resection of pancreatic body and tail cancer

On May 17, 2019, pathology revealed the following: 1. (Pancreas, spleen, left adrenal gland) resection specimens: (Pancreas) Combined with morphological and immunohistochemical results, the lesion was consistent with moderately-to-poorly differentiated adenosquamous carcinoma, with small foci exhibiting sarcomatoid structures and focal areas accompanied by significant fibrosis. No definite intravascular thrombi or neural invasion was observed. No cancer was detected at the pancreatic resection margin, no definite metastasis was found in the lymph nodes surrounding the pancreas, and no definite cancer involvement was observed in the spleen and adrenal glands. 2. (Hepatic artery nerve plexus resection margin) was examined and found to consist of fibrous adipose connective tissue and nerve fiber bundles, with no cancer detected. 3. (Celiac artery mesenteric nerve plexus) was examined and found to consist of fibrous adipose connective tissue and nerve fiber bundles, with no cancer observed.

From June 25, 2019 to September 24, 2019, received adjuvant chemotherapy with a 4-cycle regimen of gemcitabine plus temozolomide.

On June 18, 2019, abdominal CT reexamination showed: after resection of the pancreatic body and tail, spleen, and left adrenal gland; the fluid accumulation in the abdominal and pelvic cavity decreased compared to before.

On September 25, 2019 CT showed: 1. A few fibrous streaks in both lungs 2. Small nodules in the lower lobe of the left lung.

On September 26, 2019, an MR plain scan of the upper abdomen showed: changes after resection of the pancreatic body and tail and spleen, as well as the left adrenal gland; suspicious abnormal signals in the residual pancreatic parenchyma, with no abnormal high signals on DWI; the abnormal signal in the right lobe of the original liver was similar to that observed previously (June 19, 2019).

On September 3, 2019, the tumor marker indicated: CEA 8.44ng/ml↑. On September 10, 2019, the tumor marker indicated: CEA 6.74ng/ml↑.

On December 10, 2019, began NKT cell immunotherapy, with a regimen of 2 courses per month. So far, 8 courses have been completed (as of the imaging review time in June 2020).

Imaging data

Abdominal MR: pancreatic body and tail, spleen, left adrenal gland resection postoperative changes, punctate slightly long T2 signal intensity visible within the residual pancreatic parenchyma, with no significant size change from September 2019 to January 2020.

Abdominal CT: no significant change in the high signal intensity areas from June 2020 compared to September 2019 and January 2020.

Abdominal MR: pancreatic body and tail, spleen, left adrenal gland resection postoperative changes, patchy slightly long T2 signal intensity visible in the right lobe of the liver, with no significant size change from September 2019 to January 2020.

Abdominal CT: Compared to September 2019 and January 2020, there was no significant change in size in June 2020.

Abdominal CT: A high-density shadow was visible in the L3 vertebral body, with no significant change in size compared to the high-signal area shown in the abdominal MRI from September 2019 and January 2020.

Abdominal CT: Mildly enlarged lymph nodes (1.2*0.8cm) were visible between the abdominal aorta and inferior vena cava, with no significant change in size compared to September 2019 and January 2020.

Lung CT: A small nodular shadow was observed in the left lower lobe, with no significant change in size from September 2019 to January 2020. It is considered to be a possible vascular shadow.

Tumor markers

Tumor marker: CEA increased in September 2019, returned to normal in January 2020, and slightly increased in May 2020; CA125 and CA19-9 are within the normal range, please pay attention to follow-up.

NKT Classic Case Review

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