摘要
目的探讨十二指肠神经内分泌癌(DNEC)的临床表现、内镜下特点、病理特征、治疗方式及预后,提高其诊疗水平。方法回顾性分析青岛大学附属医院2006年12月至2014年12月确诊的DNEC9例临床资料。结果9例患者中,男性6例,女性3例,发病年龄48~75岁不等,平均61.5岁,男女比例2:1。主要临床表现包括上腹痛7例,皮肤巩膜黄染4例,黑便1例,1例无症状。病变好发于十二指肠降段,多为单发。5例行胰十二指肠切除术,2例行局部手术切除,1例行胃大部切除术,1例行逆行胰胆管造影胆管支架置入术(ERCP)缓解症状。术后随访3~40个月。5例行根治性切除患者,4例健在,1例发生肝转移而死亡;4例行姑息性治疗患者,1例健在,2例死亡,1例失访。结论DNEC临床表现无特异性,内镜及病理免疫组化检查是早期诊断的重要手段,应积极手术治疗,改善患者预后。
Objective To'sturdy the clinical manifestations, endoscopic features, pathological fea- tures, treatment and prognosis of patients with duodenal neuroendocrine carcinoma (DNEC). Methods The clinical data of 9 patients with duodenal neuroendocrine carcinoma who were admitted to our hospital from December 2006 to December 2014 were retrospectively analyzed. Results There were 6 males and 3 females. The mean age was 61.5 years (range 48 -75 years). The clinical manifestations were abdominal pain ( n = 7 ) , jaundice ( n = 4 ) , melena ( n = 1 ) and asymptomatic ( n = 1 ). The DNEC was usually solita- ry in the duodenum. The operations included duodenopancreatectomy ( n = 5 ), surgical resection ( n = 2), subtotal gastrectomy ( n = 1 ), and 1 patient was palliated by common bile duct stenting using an endoscopic retrograde cholangio-pancreatographic (ERCP) approach. The patients were followed up for 3 -40 months after operation. For the 5 patients who underwent radical excision d were alive. One patient died from liver metastasis. For the 4 patients who underwent palliative therapy, one was alive, two died and one lost to follow-up. Conclusions The clinical manifestations of duodenal neuroendocrine carcinoma were non-speci- fic. Endoscopic, pathologic and immumohisotochemical tests were important in the diagnosis. Surgical resec- tion improved the prognosis of these patients.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2015年第8期544-547,共4页
Chinese Journal of Hepatobiliary Surgery
基金
山东省中青年科学家科研奖励基金(BS2011YY004)
关键词
十二指肠
神经内分泌癌
诊断
治疗
Duodenum
Neuroendocrine carcinoma
Diagnosis
Treatment