Clinicopathological Features And Prognosis Of 88 Patients With Primary Duodenal Tumors

Objective: We retrospectively analyzed 88 patients’ cases of primary duodenal tumor arising in the nonpapillary region,to explore the clinical pathological characteristics of primary duodenal tumor,analyze the surgical treatment of primary duodenal tumor,discusse factors that affect the prognosis of patients with primary duodenal tumors,and to improve the early diagnosis of primary duodenal tumor,and treatment。Methods:We retrospectively analyzed the clinicopathological data of patients with nonpapillary primary duodenal tumor who underwent surgical resection in the Hepatobiliary Department of the Fourth Hospital of Hebei Medical University from February 2009 to January 2021.Including: general information,clinical manifestations,past history,personal history and family history,auxiliary examination(including imaging and laboratory examination),surgical methods,pathological results and complications.Long term survival was obtained by telephone followup and medical records.SPSS26.0 software was used for statistical analysis,independent t test,chisquare test and Fisher test were used,KaplanMeier method was used for univariate analysis and survival curves were drawn,logrank test was used to compare survival curves among groups,P<0.05 was considered statistically significant.Results:1.A total of 88 patients with PTD were included in this study,including 47 males(53.4%)and 41 females(46.6%),with an overall mean age of 57.22 years.2.Lack of specific clinical symptoms,the most common symptoms are anaemia(64.8%),abdominal pain(42.0%),abdominal distension(37.5%)and nausea(25.0%).3.The site of tumor occurrence was bulbar in 17(19.30%),descending in 49(55.70%),horizontal in 8(9.10%),horizontal in 12(13.60%),and ascending in 2(2.30%).Final histopathology showed stromal tu mor in 35 cases(39.80%),adenocarcinoma in 32 cases(36.40%),lymp homa in 3 cases(3.40%),neuroendocrine tumor in 7 cases(8.00%),ot her pathological types in 11 cases(12.5%),respectively,malignant my ofibroblastic tumor in 1 case,hamartoma in 1 case,nerve sheath tumor in 1 case,adenomatous hyperplasia in 4 cases,villous tubular adenom a in 4 cases.The 88 surgical modalities included 51 pancreatoduodenect omies,33 local resections,and 4 endoscopic treatments.4.The overall 1,3,and 5year survival rates were 94.3%,85.2%,and 79.5%,respectively,among which the 1,3,and 5year survival rates were 100%,97.1%,91.4% for stromal tumors,93.8%,75.5%,and 65.6% for adenocarcinomas,85.7% for neuroendocrine tumors,33.3% for lymphomas,and no deaths occurred among other benign tumor s.5.The results of univariate analysis suggested that karyotype was a risk factor for survival of patients with stromal tumors。Conclusions:1.PTD lacks specific clinical manifestations,has a high rate of misdiagnosis,and is easily overlooked.2.PTDs are mainly stromal tumors and adenocarcinoma.Mitotic imaging is a risk factor for the survival of patients with stromal tumors.Adjuvant targeted therapy should be taken to improve the prognosis of patients with middle and high risk.Compared with patients with stromal tumors,the prognosis of adenocarcinoma is poor,with a 5year survival rate of 65.6%.Combined with clinical manifestations and auxiliary examination is the main means of early diagnosis.3.Most of PTD patients lack specific tumor markers.Gastroscopy and CT are important means to diagnose PTD.According to the biologyical characteristics of tumor,appropriate surgical methods should be adopted to improve the survival rate.