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十二指肠腺癌的临床病理特征和预后及其与壶腹和胰管腺癌的比较。

Clinicopathologic features and prognosis of duodenal adenocarcinoma and comparison with ampullary and pancreatic ductal adenocarcinoma.

机构信息

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030.

出版信息

Hum Pathol. 2013 Dec;44(12):2792-8. doi: 10.1016/j.humpath.2013.07.030. Epub 2013 Oct 15.

Abstract

Because of the rarity of duodenal adenocarcinoma (DAC), the clinicopathologic features and prognostication data for DAC are limited. There are no published studies directly comparing the prognosis of DAC to that of ampullary adenocarcinoma (AA) and of pancreatic ductal adenocarcinoma (PDA) after resection. In this study, we examined the clinicopathologic features of 68 patients with DAC, 92 patients with AA, and 126 patients with PDA who underwent resection. Patient clinicopathologic and survival information were extracted from medical records. Statistical analysis was performed using Statistical Package for the Social Sciences with 2-sided significance level of .05. Patients with DAC had higher American Joint Committee on Cancer (AJCC) stage than AA patients (P = .001). Lymph node metastasis (P = .013) and AJCC stage (P = .02) correlated with overall survival in DAC patients. Patients with DAC or AA had lower frequencies of lymph node metastasis and positive margin and better survival than those with PDA (P < .05). However, no differences in nodal metastasis, margin status, or survival were observed between DAC patients and those with AA. Our study showed that lymph node metastasis and AJCC stage are important prognostic factors for overall survival in DAC patients. Patients with DAC had less frequent nodal metastasis and better prognosis than those with PDA. There was no significant difference in prognosis between DAC and AA.

摘要

由于十二指肠腺癌(DAC)较为罕见,DAC 的临床病理特征和预后数据有限。目前尚无研究直接比较 DAC 与壶腹腺癌(AA)和胰腺导管腺癌(PDA)切除术后的预后。本研究分析了 68 例 DAC、92 例 AA 和 126 例 PDA 患者的临床病理特征,这些患者均接受了手术治疗。从病历中提取患者的临床病理和生存信息。使用社会科学统计软件包(双侧显著性水平为.05)进行统计分析。DAC 患者的美国癌症联合委员会(AJCC)分期高于 AA 患者(P =.001)。淋巴结转移(P =.013)和 AJCC 分期(P =.02)与 DAC 患者的总生存相关。DAC 或 AA 患者的淋巴结转移和阳性切缘频率以及生存率均低于 PDA 患者(P <.05)。然而,DAC 患者与 AA 患者之间的淋巴结转移、切缘状态或生存无差异。本研究表明,淋巴结转移和 AJCC 分期是 DAC 患者总生存的重要预后因素。DAC 患者淋巴结转移频率较低,预后较好。DAC 与 AA 的预后无显著差异。

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