原发性十二指肠恶性肿瘤41例分析

目的　总结原发性十二指肠恶性肿瘤的常见临床类型、病理特征及诊断方法。方法　对我院 1981年 1月 - 2 0 0 2年 6月收治并经病理证实的 4 1例原发性十二指肠恶性肿瘤进行回顾性分析。结果　病理类型 :腺癌 35例 ,平滑肌肉瘤 4例 ,类癌 1例 ,淋巴瘤 1例。部位 :十二指肠第 2段 6 5 .85 % (2 7 4 1) ,其中乳头区 2 2例 ;球部 2 4 .39% (10 4 1) ;水平段 3例 ;升段 1例。常见临床症状依次为上腹痛 5 3.6 8% ,贫血4 8.78% ,黄疸 4 6 .34% ,上消化道出血 2 9.2 7% ,消瘦 2 4 .39%。诊断手段 :内镜、低张钡餐、B超、CT及MRCP等检查可提高十二指肠肿瘤的检出。结论　原发性十二指肠恶性肿瘤以腺癌为主 ,好发于第 2段 ,但第 1段并不少见 ;早期临床表现没有特异性 ,联合应用内镜及影像学检查可提高检出率

Primary malignant tumor of the duodenum--A retrospective analysis of 41 cases

Objective To investigate clinical manifestations, histopathological patterns and effective diagnostic methods for primary malignant tumors of the duodenum (PMTD). Methods The data of 41 cases of PMTD confirmed by pathological examination admitted from 1981 to 2002 in our hospital were retrospectively analyzed. Results Of the 41 primary malignant tumors, 35 were adenocarcinoma, 4 leiomyosarcoma, 1 carcinoid and 1 lymphoma. Most of the tumors were located in descending portion of duodenum (27 cases, 65.85%), especially around the papilla (22 cases), 10 of them were located in duodenal bulb (24.39%), 3 and 1 were in horizontail part and ascending of duodenum respectively. The common clinical manifestations were abdominal pain (53.68%), anemia (48.78%), jaundice (46.36%), GI hemorrhage (29.27%), weight loss (24.39%). Endoscopy, upper GI barium meal, BUS, CT, and MRCP were also useful for tumor of duodenum. Conclusions Adenocarcinoma predominates among PMTD and the predilection sites are the descending portion but also duodenal bulb. Specific symptom and sign were usually lacking in early stage. Combination of endoscopy and imaging examination was useful for diagnosis.