浅表非壶腹部十二指肠上皮肿瘤的诊断及治疗进展  

Progress in diagnosis and treatment of superficial non-ampullary duodenal epithelial tumor

作　　者：卡迪尔娅·艾克拜尔 程永波[1] Kadierya·AIKEBAIER;CHENG Yongbo(Department of Gastroenterology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院消化病一科,新疆乌鲁木齐830011

出　　处：《胃肠病学和肝病学杂志》2025年第2期288-291,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：浅表非壶腹部十二指肠上皮肿瘤(superficial non-ampullary duodenal epithelial tumor,SNADET)包括腺瘤和局限于黏膜下层的腺癌,虽罕见但具有恶性转化风险。十二指肠恶性肿瘤因高发病率、死亡率及预后差而备受关注,多数患者确诊时已为中晚期,失去最佳手术时机。因此,早期诊断和干预SNADET至关重要,特别对于有胃肠道恶性肿瘤家族史的患者,可预防十二指肠腺癌发生。术前内镜诊断对偶发性SNADET治疗至关重要,良性或低级别腺瘤可随访观察,而高级别腺瘤和腺癌则需内镜下黏膜切除术(endoscopic submucosal resection,EMR)、内镜下黏膜剥离术(endoscopic submucosal dissection,ESD)或手术切除。EMR多行局部切除,ESD整体切除率高且并发症风险也高。腹腔镜-内镜联合手术展现出良好切除率和低并发症风险,但费用昂贵且需专家操作。本文综述了SNADET的最新诊断与治疗进展。Superficial non-ampullary duodenal epithelial tumor(SNADET),which include adenomas and adenocarcinomas confined to the submucosal layer,is rare but carries a risk of malignant transformation.Duodenal malignancies are of significant concern due to their high incidence,mortality rates,and poor prognosis,with most patients diagnosed at advanced stages,missing the optimal surgical intervention window.Therefore,early diagnosis and intervention for SNADET are crucial,particularly for patients with a family history of gastrointestinal malignancies,as this can help prevent the development of duodenal adenocarcinoma.Preoperative endoscopic diagnosis is essential for the management of incidental SNADET;benign or low-grade adenomas can be monitored,while high-grade adenomas and adenocarcinomas require endoscopic mucosal resection(EMR),endoscopic submucosal dissection(ESD),or surgical resection.EMR typically involves local excision,while ESD offers a higher complete resection rate but comes with increased risk of complications.Laparoscopic-endoscopic cooperative surgery has demonstrated favorable resection rates and low complication risks,although it is costly and requires expert handling.This article reviewed the latest advancements in the diagnosis and treatment of SNADET.

关 键 词：非壶腹部浅表十二指肠上皮肿瘤 内镜下黏膜切除术 内镜下黏膜剥离术 

分 类 号：R735[医药卫生—肿瘤]