伴有十二指肠侵犯的胃癌的临床病理研究

Clinicopathologic study of gastric carcinoma with duodenal invasion.

作者信息

Perng D S, Jan C M, Wang W M, Chen L T, Liu C S, Huang T J, Chen C Y

机构信息

Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China.

出版信息

Kaohsiung J Med Sci. 1996 Aug;12(8):461-5.

PMID:8774114

Abstract

Clinicopathologic features of 319 patients who underwent gastrectomy for adenocarcinoma of stomach were studied whether disease involved duodenum or not. Thirty-eight patients (11.9%) had duodenum invasion. Gastric carcinoma with duodenal invasion was most often Borrmann III or Borrmann IV (65.8%) type, with pylorous invasion by endoscopy (39.5%), large tumor size (73.7% > or = 5cm), lymph node metastasis (78.9%), serosal invasion (97.4%) and the incidence of the resection line not being free was high (13.2%). Duodenal invasion was most often (55.3%) direct through the deep layer or through lymphatics or venules. We need to pay more attention to finding duodenum invasion. More than 3 cm width of duodenal resection is recommended if duodenum invasion is suspected.

摘要

对319例行胃癌切除术的患者的临床病理特征进行了研究，观察疾病是否累及十二指肠。38例患者（11.9%）发生十二指肠侵犯。伴有十二指肠侵犯的胃癌最常见为Borrmann III型或Borrmann IV型（65.8%），内镜检查显示幽门侵犯（39.5%），肿瘤体积大（73.7%≥5cm），有淋巴结转移（78.9%），浆膜侵犯（97.4%），切缘无癌残留的发生率高（13.2%）。十二指肠侵犯最常见（55.3%）的方式是直接侵犯深层或通过淋巴管或小静脉。我们需要更加注意发现十二指肠侵犯。如果怀疑有十二指肠侵犯，建议十二指肠切除宽度超过3cm。