Clinical Analysis Of161Cases Of Primary Duodenal Malignant Tumors

Objective:1.To research the sites, pathological type and othercharacteristics of the primary duodenal malignant tumors, especiallydifferences in young and middle-aged and elderly patients.2. To find out jointinspection methods that may diagnose the disease early and relativelyinexpensive.3. To explore relative specificity of serological tumor markers ofthe disease, and factors that affect the tumor marker serum levels. According tothe results, we explore its application in the diagnosis and treatment of diseasedetection.Methods: The statistics of160cases of diseased parts, the first symptoms,and the detection rate of the relevant checks, pathological features, andabnormal serum tumor markers of primary duodenal malignant tumors. Toexplore their respective characteristics and the value of early diagnosis of thedisease， firstly, the paper analyses the differences of the first symptom,anatomical site, pathological type, age, gender, etc according to clinicaldata.Secondly, to further explore the detection rate of lesions of variousauxiliary examination, pathological type, etc; to explore the relative specificityof serological tumor markers, then to explore its application in the diagnosis,treatment of the disease and postoperative detection.Statistics: Using SPSS18.0for statistical analysis, Use the mean±standard deviation to express numeric variable data. χ2test is used for analysisof the overall distribution of the normal distribution of the count data using;Using a rank sum test to analysis if overall does not meet the normality ofthe distribution of count data. The differences were statistically significant withP <0.05.Results: Young group and older group, with no specific clinical manifestations, complain of abdominal pain, bloating, abdominal pain, skinstained yellow sclera, dark urine, nausea, vomiting, hematemesis, melena andother performance. The average duration from onset to diagnosis is2.3months.The tumors in young group patients mainly occur in the duodenal papilla,followed by a descending part (excluding nipple), then followed by the bulb,the horizontal part.The junction between horizontal part and ascending part ofduodenum. The tumors in elder group patients mainly occur in descending part(excluding nipple),then the duodenal papilla, followed by a descending part(excluding nipple), then followed by the papilla, bulbar, ascending part, thehorizontal part,then junction between horizontal part and ascending part ofduodenum. There has no significant difference in the in the pathological typebetween Two groups. The manly pathological type of the young group patientsare adenocarcinoma, followed by malignant stromal tumor, carcinoid,mucinous adenocarcinoma. In addition, there also exist one case of visiblemalignant lymphoma and one case of small cell tumors. The manlypathological type of the older group patients are adenocarcinoma, followed bymalignant stromal tumor, carcinoid, mucinous adenocarcinoma. In addition,there also exist one case of visible undifferentiated carcinoma, nippleadenosquamous carcinoma, adenocarcinoma with mucinous adenocarcinomaand adenocarcinoma, and some signet-ring cell carcinoma. There has nosignificant difference in the incidence of site between Two groups.The highestdetectable rate of Auxiliary examination is duodenoscope, followed byERCP.then gastroscopy, enhanced CT, enhanced MRI, MRI, plain CT scan,B-ultrasound. Tumor marker CA199has the highest specificity and sensitivity.The highest detectable rate methods of serological detection are γ-GT andCA199. The combination of these multiple examination can improve thediagnostic rate.Conclusion:1.Primary duodenal malignant tumors is lack of specific clinical manifestations and difficult to detection early.2. There’s no statisticaldifference in the diseased parts and pathological type of the elderly and youngpatients. They mainly occur in the papilla. The most pathological types of thetwo groups are adenocarcinoma.3. The key to promoting survival rate ofprimary duodenal malignant tumors is early diagnosis; early diagnosis dependson full awareness of the disease. When patients with clinical manifestations ofabdominal pain, bloating, skin, sclera stained yellow, etc., and those which cannot be explained with common diseases, they should arouse our vigilance. Anumber use of assisted check of ERCP, duodenoscopy, endoscopy, CT, Bultrasonic can achieve the purpose of early diagnosis. The use of duodenoscopeor EUS with enhanced CT can improve detection rate.4. Primary duodenalmalignant tumors are lack of relative specificity of serological markers, but theCEA and CA199have high value in early diagnosis of the disease. It has a widerange of applications in postoperative detection.