209例原发性十二指肠癌患者的病例分析  

Clinical analysis of 209 patients with primary duodenal carcinoma

作　　者：刘俊宝 远丽芳 崔成旭 王琦 张苗苗 王静 李伟功 侯立杰 LIU Junbao;YUAN Lifang;CUI Chengxu;WANG Qi;ZHANG Miaomiao;WANG Jing;LI Weigong;HOU Lijie(Deparment of General Ward 3,Sanhuan Tumor Hospital of Chaoyang District,Beijing 100122,China;Department of Oncology,Huanxing Tumor Hospital of Chaoyang District,Beijing 100122,China;Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]北京市朝阳区三环肿瘤医院综合三病区,北京100122 [2]北京市朝阳区桓兴肿瘤医院肿瘤内科,北京100122 [3]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院内科,北京100021

出　　处：《癌症进展》2018年第15期1922-1925,1932,共5页Oncology Progress

摘　　要：目的探讨原发性十二指肠癌(PDC)的临床特点和诊治方法。方法收集209例PDC患者的临床资料,分析患者的临床表现。结果 PDC患者的主要临床表现为上腹部不适、黄疸、上腹部疼痛、恶心呕吐及体重减轻等。发病部位:降部152例,球部25例,水平部14例,升部2例,发病部位不明确16例。病理类型以中分化腺癌多见。糖类抗原19-9(CA19-9)的阳性表达率为49.69%,高于癌胚抗原(CEA)的36.08%,差异有统计学意义(P﹤0.05)。209例PDC患者中,133例PDC患者行原发灶切除术,76例患者的原发病灶未切除,其中,49例PDC患者行姑息性旁路术。共112例患者出现转移(初始诊断转移85例,术后转移27例),转移部位以淋巴结转移和肝转移较为多见。112例出现转移的患者中,接受姑息性化疗者65例。结论 PDC早期的临床表现缺乏特异性,手术为其主要的治疗方法,CA19-9对PDC具有一定的诊断价值。Objective To investigate the clinical feature,diagnosis and treatment of primary duodenal carcinoma(PDC).Method The clinical records of 209 patients with PDC diagnosed were reviewed retrospectively and the clinical characteristics of patients were analyzed.Result The most common symptoms were epigastric discomfort,jaundice,epigastric pain,nausea,vomiting and weight loss.Pathogenic sites:152 casesin the descending part,25 cases in the bulb part,14 cases in the horizontal part,2 cases in ascending part and 16 cases with unclear location.The pathologic types were mostly moderately differentiated adenocarcinoma.The positive rate of carbohydrate atigen 19-9(CA19-9)was 49.69%,which was significantly higher than that(36.08%)of carcinoembryonic antigen(CEA)(P<0.05).Among 209 patients with PDC,133 cases underwent surgical resection of their primary disease while 76 cases haven’t,among whom 49 cases underwent a palliative bypass surgery.A total of 112 patients showed metastasis(85 cases were initially diagnosed and 27 cases were postoperatively diagnosed),lymph node metastases and liver metastases were the most common.Of the 112 patients with metastasis,65 patients received palliative chemotherapy.Conclusion Patients with PDC often present with non-specific symptoms and surgery is the primary treatment.CA19-9 has a certain value in diagnosis for PDC.

关 键 词：原发性十二指肠癌 腺癌 病理特征 临床治疗 胰十二指肠切除术 

分 类 号：R735.3[医药卫生—肿瘤]