原发性十二指肠恶性肿瘤临床影像病理学研究

目的　探讨原发性十二指肠恶性肿瘤的临床表现、病理学特征影像学诊断及治疗方法 .方法　对 82例原发性十二指肠恶性肿瘤患者的临床资料进行回顾性分析 .结果　本组患者发病部位乳头区 5 3例、降段 18例 .临床表现依次为上腹疼痛 5 7例、黄疸 5 3例、消化道出血 4 1例 .乳头区肿瘤多表现为腹痛、黄疸 ,乳头区以外肿瘤常则多表现为腹痛、黑便及腹部包块 .病理学类型以腺癌多见 (72例 ) ,平滑肌肉瘤 (5例 )、恶性淋巴瘤 (3例 )次之 .结论　原发性十二指肠恶性肿瘤以上腹痛、黄疸、消化道出血为主要表现 ,但缺乏特征性 .病理类型以腺癌为主 ,好发于十二指肠乳头区及降段 .CT、B超和内镜检查是主要诊断手段 .手术切除是原发性十二指肠恶性肿瘤的主要治疗方法 ,早期诊断是改善患者预后的关键

The Clinical Imageing and Pathological Study of Primary Malignant Tumors of the Duodenum

Objective To investigate the clinical manifestations, histopathological patterns,imageing diagnostic and treatment measuremen of primary malignant duodenal tumors. Methods The data of 82 patients with primary malignant duodenal tumors confirmed by pathology admitted in our hospital during 10 years from Oct.1993 to Oct.2003 were analyzed retrospectively. Results Of all these 82 patients with primary malignant tumors, 72 were adenocarcinoma, 5 leiomyosarcoma, and 3 malignant lymphoma. Tumors located around the peripapilla region 53 cases, in the descending portion of the duodenum 18 cases. The common presenting symptoms and signs were abdominal pain 57 cases, jaudice 53 cases, melena 41 cases. These patients with primary malignant duodenal tumors around the peripapilla region were more likely to present with abdominal pain and jaudice. While, these patients with primary malignant duodenal tumors in descending portion of the duodenum were more likely to present with abdominal pain, melena and abdominal mass. The histopathological patterns were adenocarcinoma in 72 cases, leiomyosarcoma in 5 cases and malignant lymphoma in 3 cases. Conclusions Adenocarcinoma predominates among primary malignant duodenal tumors, which locating most of around the peripapilla region and in the descending portion. The common presenting symptoms and signs were abdominal pain, jaudice and melena. But these patients usually lack specific symptoms and signs in early stage of disease. CT, B ultrasound and gastroduodenoscopy are the main diagnosis measurement of primary duodenal malignant tumors. Operative resection is the main administration methods, and early diagnosis is the key to improve the patient prognosis.