| 吕厚君吴向坤△ 周学伟熊元刚李阳.原发性十二指肠恶性肿瘤的临床分析[J].,2011,11(19):3675-3677 |
| 原发性十二指肠恶性肿瘤的临床分析 |
| Clinical Analysis of PrimaryMalignant Duodenal Tumor |
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| DOI： |
| 中文关键词: 十二指肠肿瘤 诊断 预后 |
| 英文关键词: Duodenal tumor Diagnosis Prognosis |
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| 中文摘要: |
| 目的：探讨原发性十二指肠恶性肿瘤的临床特点、诊断方法和预后影响因素。方法：回顾性分析随访资料完整的45 例原发
性十二指肠恶性肿瘤患者的临床病理资料。结果：腺癌33 例（73.3 %）为主要的病理类型。主要临床表现为腹痛、上腹部不适、黄
疸、消化道出血等。胃十二指肠镜、内镜逆行胰胆管造影（Endoscopic Retrograde Cholangio-Pancreatography, ERCP）、十二指肠低张
造影、超声内镜、CT 及B 超确诊率分别为91.1 %(41/45)，93.3 % (42/45)，82.2 %(37/45)，75.6 %(34/45)，68.9 %(31/45) 及26.7 %
(12/45)。本组45 例均行开腹手术，包括根治性手术，胰十二指肠切除术36 例；姑息性手术，胃肠吻合术2 例、肿瘤局部切除术5
例、短路手术2 例。根治术和姑息术后5 年生存率分别为46.7％和4.4％，两组生存率差异有统计学意义（P<0.05）。对全组45 例患
者的预后因素进行Cox 回归分析的结果显示，手术方式、肿瘤浸润深度和淋巴节转移是影响预后的独立危险因素（均P<0.05）。结
论：原发性十二指肠恶性肿瘤缺乏特异性临床表现；胃十二指肠镜、ERCP 以及十二指肠低张造影等联合检查可提高诊断率；根治
性手术远期疗效较好；淋巴结转移和局部侵犯是肿瘤预后不良的重要影响因素。 |
| 英文摘要: |
| Objective: To investigate the Clinical features, diagnostic methods and prognosis of primary malignant tumor of the
duodenum. Methods: We retrospectively analyzed the clinicopathological data from 45 patients with primary duodenal malignancy seen
in our hospital from 1998 to 2008. Results: 33 cases of adenocarcinoma (73.3 %) as the main pathological types. The main clinical manifestations
were abdominal pain, upper abdominal discomfort, jaundice, gastrointestinal bleeding.The correct diagnosis rate for Gastric
duodenoscopy 91.1 %(41/45)，for ERCP 93.3 % (42/45)，for duodenography 82.2 %(37/45)，for EUS 75.6 % (34/45)，for ultrasound
examination 68.9 %(31/45), for CT 26.7 % (12/45)，respectively. All of the 45 patients received surgery including radical surgery: pancreaticoduodenectomy
(36 patients); palliative surgery: gastrointestinal anastomosis (2 patients), local tumor resection (5 patients),
short-circuit operation (2 patients). The 5 year survival rate of radical surgery and palliative were 46.7 %and 4.4 % respectively. There
was a significant diference between the two groups（P<0.05）. The multivariate analysis showed that surgical procedure, depth of invasion
and lymph node metastasis were independent prognostic risk factors (P <0.05). Conclusions: Primary malignant tumor of the duodenum
lack of specific clinical manifestations; Gastric duodenoscopy, ERCP and angiography, hypotonic duodenum of the joint inspection may
improve the rate of diagnosis. Radical resection have better long-term effect. Lymph node metastasis and local invasion were important
adverse prognostic factors. |
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