原发性十二指肠腺癌临床分析  

Clinical analysis of primary adenocarcinomas of the duodenum

作　　者：李旭[1] 吴卫东[1] 金涛[1] 刘俊[1] 

机构地区：[1]上海交通大学附属第一人民医院普外科,200080

出　　处：《腹部外科》2005年第3期149-150,共2页Journal of Abdominal Surgery

摘　　要：目的总结原发性十二指肠腺癌好发部位、常见临床表现和诊治方法,探讨提高其生存率的有效方法.方法回顾性分析我院1994年7月～2004年6月收治并经病理学证实的31例原发性十二指肠腺癌.结果全组31例中有21例(68%)发生于十二指肠乳头区.全组病例AJCC分期,Ⅰ期4例,Ⅱ期1例,Ⅲ期15例,Ⅳ期11例.13例行肿瘤根治术,其1年生存率91.7%,3年生存率47%,5年生存率23.4%,中位生存时间31.7月;18例行姑息性手术的存活均未超过1年,中位生存时间4.6月.结论原发性十二指肠腺癌症状无特异性,早期不易发现,确诊多已晚期.内镜和胃肠造影检查是有效的确诊手段.提高原发性十二指肠腺癌早期诊断率,可以提高肿瘤根治率,进而可能改善预后,提高生存率.Objective To investigate location, clinical manifestations, and effective diagnostic and surgical methods for primary duodenal adenocarcinomas.Methods The data of 31 cases of primary duodenal adenocarcinomas were treated in our department and confirmed by pathology admitted from July 1994 to Oct. 2004 were retrospectively analyzed.Results The most common manifestations were abdominal pain (71 %) and jaudice (55 %). The main diagnostic procedures were gastroscopy and GI barium meal. Tumors mostly located in the peripapilla region of the duodenum (21 cases, 68 %). There were 4 cases of phase Ⅰ of the pathology grade, 1 case of phase Ⅱ, 15 cases of phase Ⅲ and 11 cases of phases Ⅳ respectively. All the patients with phase Ⅰ and phase Ⅱ and 8 patients with phase Ⅲ were subjected to radical operation, and the 1-, 2-, 3-year survival rate was 91.7 % , 47 % , 23.4 % respectly with the mean survival time being 31.7 months. In 18 cases subject to palliative operation, the survival time was not more than one year with mean survival time being 4.6 months.Conclusion Primary duodenal adenocarcinomas have no specificial symptoms and signs. The efficient diagnostic procedures were gastroscopy and GI barium meal. Improvement in the early diagnosis may increase the rate of radical operation and increase the survival rate.

关 键 词：癌临床分析 原发性十二指肠腺癌 2004年6月 十二指肠乳头 胃肠造影检查 生存时间 1994年 回顾性分析 肿瘤根治术 3年生存率 5年生存率 姑息性手术 早期诊断率 好发部位 诊治方法 临床表现 有效方法 AJCC 改善预后 病理学 

分 类 号：R736.1[医药卫生—肿瘤] R735.31[医药卫生—临床医学]