原发性十二指肠癌44例内镜分析.docVIP

原发性十二指肠癌44例内镜分析 　　摘要:目的: 总结原发性十二指肠癌的年龄分布、内镜下分布、形态特点及病理分型，以提高临床内镜诊疗水平。 方法:: 收集我院1999~2014年内镜下诊断明确的原发性十二指肠癌44例进行回顾性分析。 结果:患者性别及年龄：男性50岁以下6例，50-60岁12例，60岁以上12例；女性50以下5例，50-60岁1例，60岁以上8例；病变部位：十二指肠球部12例，降段29例，水平部3例；肿瘤分型：腺癌38例，粘液腺癌3例，类癌2例，印戒细胞癌1例；镜下分型：外生型19例，溃疡性22例，浸润型3例。结论: 原发性十二指肠癌以降段好发，病理类型以腺癌为主，临床表现多不典型，并有年轻化倾向，内镜下多表现为外生型和溃疡型，早期诊断和手术治疗是关键。 　　关键词:十二指肠癌；内镜检查；诊断 　　中图法分类号: R735.35 　　Abstract:ObjectivesTo explore the features of age distribution, location and morphology in endoscopy, and pathologic type of primary duodenal carcinoma, so to improve the levels of diagnosis and treatment.MethodsThe clinical data and endoscopic findings of 44 cases of primary duodenal carcinoma(from affiliated hospital of Zunyi medical college, 1999-2014) were retrospectively analyzed.Results The characteristics of gender and age: for male: 6 cases under the age of 50, 12 cases between 50 to 60, 12 cases over 60, and for female: 5 cases under 50, only one case between 50 to 60, 8 cases over 60. The fetures of location in endoscopy: 12 cases were located in duodenal bulb, 29 cases in descending portion of duodenum, and 3 cases in leveling portion. The pathological types: 38 cases were adenocarcinoma, 3 cases were mucinous carcinoma, 2 cases were carcinoid, and 1 case was signet ring cell cancer. The endoscopic types: 19 cases were exogenic, 22 cases were ulcerative and 3 cases were infiltrative.Conclusions The primary duodenal carcinoma occurs in descending portion more than in other portions of duodenum.The adenocarcinoma is the main pathologic type. The clinical manifestations is always atypical, and the age of onset tends to be young. The exogenic and ulcerative are the mail endoscopic types. The key of diagnosis and treatment of primary duodenal carcinoma is early diagnosis and surgical treatment. 　　Key words:Primary duodenal carcinoma; Endoscopy; Diagnosis. 　　原发性十二指肠癌（Primary duodenal carcinoma，PDC）是指原发于十二指肠各段的恶性肿瘤，但是不包括Veter壶腹、胆总管下段及胰头部的肿瘤。本病临床较为少见，发病率较低，多缺乏典型的临床症状和体征，极易误诊和漏诊，而内