Analysis Of Clinical Features And Risk Factors Of Ampulla Of Vater Cancer

Objective:To summarize the clinical onset characteristics of the ampulla of Vater cancer, ampulla of Vater cancer-specific risk factors to explore the risk factors of the ampulla of Vater cancer, designed to provide a strong reference to the ampulla of Vater cancer prevention and clinical treatment, improve the prognosis of patients.Methods:(1) Cluster sampling were analyzed retrospectively to the Hunan Provincial People’s Hospital of Hepatobiliary Surgery between January2003to2011in October clinically diagnosed cases of the ampulla of Vater cancer data to explore the clinical features of cancer of the ampulla of Vater.(2) Random sampling to extract the same period the average patient data were analyzed to establish the case-control model to explore the specificity of the ampulla of Vater cancer risk factors.(3) The frequency of exposure in case-control model with non-exposed, calculate the OR and the interval of the odds ratio estimate (95%CI), odds ratio for hypothesis testing, analysis of risk factors for cancer of the ampulla of Vater.Results:(1) For the clinical diagnosis of clinical data of192cases of cancer of the ampulla of Vater summary found the ampulla of Vater cancer incidence of male to female ratio was0.81:1, age at onset was62.21±9.08years old, male and female between the age no significant difference (P>0.05). The main clinical manifestations of the ampulla of Vater cancer, jaundice, and intermittent abdominal pain, varying degrees accompanied by abdominal discomfort, intermittent fever, diarrhea, back pain, black stools and other symptoms; of Vater ampullary carcinoma in patients with blood mainly hemoglobin (HB), white blood cell (WBC), platelet (PLT) dysfunction, liver and kidney dysfunction, alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyl transferase (GGT), alkaline phosphatase (ALP) total bilirubin (TBILI), direct bilirubin (DBILI) different degrees of increase in indirect bilirubin (IBILI), total protein (TP), albumin (ALB), globulin (GLB)-based; major changes in the nucleoprotein examination-based, may be associated with abnormal serum protein electrophoresis, electrolytes and coagulation full set of functions damage to CA19-9, CEA, CA242, CA125and, AFP, such as increased; imaging check preferred B-ultrasound, but CT and MRI can better determine the location of the tumor, the size and nature, diagnosis requires ERCP biopsy; of Vater ampuliary cancer surgery, pancreatic bile duct resection and local excision in the patient’s hospital stay postoperative hospital stay, operative time and blood loss volume of significant differences (P<0.05), complications of the former than the latter, postoperative complications, pancreatic leakage.(2)Through a professional medical record information retrieval system, cluster sampling of192cases of ampulla of Vater cancer data and200cases of the general patient information, the establishment of case-control model, the cases and control groups in gender, age, occupation, marital status Hometown was no significant difference (P>0.05).(3)Single-factor analysis of cholecystitis, cholelithiasis, viral hepatitis and liver dysfunction, hyperbilirubinemia and ampulla of Vater cancer association (P<0.05), and smoking, drinking, stomach disease, pancreatitis, enteritis, and ampullary benign tumors as well as a relative of malignancy association was not statistically significant (P>0.05).(4)Multivariate analysis revealed that cholecystitis, viral hepatitis, cholelithiasis, liver function, mild, moderate, severe damage and hyperbilirubinemia seven factors of ampulla of Vater cancer risk factors, associated with a statistically significance (P<0.05).(5) PLT abnormalities in the blood, liver and kidney function indexes TBIL and TBA and GGT, ALP, and AST case group and control group differences were statistically significant (P<0.05).Conclusion:(1)Vater of ampullary cancer, male, female age was no significant difference, the main symptom is painless jaundice, intermittent abdominal pain, blood, urine, stool, liver and kidney function, blood clotting complete set such as inspection and The nucleoprotein examination of the indicators can be used as a diagnostic marker of the ampulla of Vater cancer. B-is the preferred method of Vater’s ampulla tumors check. CT and MRI can further assist in surgery, for preoperative diagnosis possible ERCP examination. The main treatment is local excision and pancreaticoduodenectomy surgery, each with distinct characteristics of both, according to the actual situation; pancreatic leakage is the most common and most serious complications in the ampulla of Vater cancer after surgery.(2)Univariate analysis of cholecystitis, gallstones, viral hepatitis, liver dysfunction and hyperbilirubinemia ampulla of Vater cancer risk factors.(3)Multivariate analysis revealed that cholecystitis, viral hepatitis, cholelithiasis,(mild,moderate and severe) liver dysfunction and hyperbilirubinemia risk factors for cancer of the ampulla of Vater.