原发性十二指肠恶性肿瘤64例临床及预后分析  

Clinico-pathological and survival analysis of primary malignant duodenal tumors:a report of 64 cases

作　　者：张盛洪[1] 钟碧慧[1] 翁子晋[2] 龚晓蓉[1] 崔毅[1] 陈旻湖[1] 

机构地区：[1]中山大学附属第一医院消化内科,广州510080 [2]中山大学附属第一医院病理科,广州510080

出　　处：《中国实用内科杂志》2009年第2期144-146,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨我国南方地区原发性十二指肠恶性肿瘤的临床、病理及预后。方法收集1997年1月至2006年12月在中山大学附属第一医院诊治的原发性十二指肠恶性肿瘤连续病例的临床资料进行回顾性分析及随访。结果共检出64例原发性十二指肠恶性肿瘤,占我院同期所有住院患者的0.02%。男性44例(68.7%),女性20例(31.3%)。中位年龄53.5岁(28～89岁)。肿瘤大部分位于降段(48例,75%),其次为球部(5例,7.8%)。常见的临床表现为腹痛或不适、贫血、恶心呕吐;病理学方面,腺癌最为常见(75%)。患者中位存活时间为38个月,早期患者(Ⅰ+Ⅱ期)(62个月)及接受根治性治疗者(62个月)的中位存活时间分别较中晚期(Ⅲ+Ⅳ期)(12个月)及保守性治疗者长(6个月)(P<0.05)。结论原发性十二指肠恶性肿瘤少见且症状缺乏特异性,主要发生于十二指肠降段,腺癌为最常见的组织学类型。早期患者及接受根治性手术治疗的患者预后较好。Objective The present study was to analyze the clinico-pathological features and outcomes of primary malignant duodenal tumors（PMDT） in Southern China. Methods All the cases with PMDT confirmed by histology and admitted to our hospital during the last 10 years（ from 1997 to 2006） were included in the study. Clinical details and histological subtyping were retrospectively analyzed. Survival information was collected. Results 64 cases of PMDT were enrolled,accounting for about 0. 02% of all the in-patients in the same period in our hospital and there were 44 males （68. 7% ） and 20 females（3/. 3% ）. The median age at diagnosis was 53. 5 years（ranging froth 28 to 89 years）. In 48 cases（75.0% ）the tumors occurred in the descending part,and 5 cases（7.8% ） in the bulb part. The top three most frequent clinical presentations were abdominal pain/discomfort, anemia, and nausea/vomiting. Histologically, adenocarcinoma was the most common type. The overall median survival for 53 patients was 38 months. Patients with early staged tumors （median survival 62 months） and accepting radical surgery（62 months） survived significantly longer than those with advanced staged tumors （ 12 months） and undertaking conservative surgery （6 months ） （P 〈 0.05 ）. Conclusion PMDT was rare and lacked specific presentations. It occurred mostly in the descending part. Adenocarcinoma was the most common histological type. Patients with radical surgery and early stage（ Ⅰ ＋ Ⅱ ） had more favorable outcome than those with conservative surgery, and late stage（ Ⅲ＋ Ⅳ ）.

关 键 词：十二指肠肿瘤 腺癌 淋巴结转移 

分 类 号：R5[医药卫生—内科学]