CAJ | 학술논문

目的评估十二指肠乳头部肿瘤术前各种检查方法的应用价值,探索一种有较高价值的诊断方法.方法回顾性分析我院1983年12月至2006年5月行十二指肠乳头部肿瘤局部切除术的25例患者术前影像学、十二指肠镜检查资料及术后病理资料.结果 25例行B型超声检查的患者中,8例发现壶腹部低回声结节,肿物检出率为32.0%(8/25);13例行CT检查的患者中3例显示壶腹部肿物图像,肿物检出率为23.1%(3/13).20例十二指肠镜检查的患者中,6例镜下见乳头部菜花样肿物,10例见瘤样肿物,经术后病理证实均为乳头肿瘤;4例镜下仪见乳头增大,术后病理结果亦为肿瘤.十二指肠镜检乳头肿物检出率为80.0%(16/20),与B型超声或CT比较,差异有统计学意义(均P<0.01).20例患者均在十二指肠镜下取活组织检查,结果12例为恶性病变,与术后病理一致;8例活组织检查提示良性病变,其中4例与术后病理一致,另4例术后病理为恶性.十二指肠镜活组织检查与最终病理诊断比较,定性诊断敏感度为80.0%(16/20).结论十二指肠镜检和镜下活组织检查诊断敏感度较高,是诊断十二指肠乳头部肿瘤有较高价值的方法.
목적 평고십이지장유두부종류술전각충검사방법적응용개치,탐색일충유교고개치적진단방법.방법 회고성분석아원1983년12월지2006년5월행십이지장유두부종류국부절제술적25례환자술전영상학、십이지장경검사자료급술후병리자료.결과 25례행B형초성검사적환자중,8례발현호복부저회성결절,종물검출솔위32.0%(8/25);13례행CT검사적환자중3례현시호복부종물도상,종물검출솔위23.1%(3/13).20례십이지장경검사적환자중,6례경하견유두부채화양종물,10례견류양종물,경술후병리증실균위유두종류;4례경하의견유두증대,술후병리결과역위종류.십이지장경검유두종물검출솔위80.0%(16/20),여B형초성혹CT비교,차이유통계학의의(균P<0.01).20례환자균재십이지장경하취활조직검사,결과12례위악성병변,여술후병리일치;8례활조직검사제시량성병변,기중4례여술후병리일치,령4례술후병리위악성.십이지장경활조직검사여최종병리진단비교,정성진단민감도위80.0%(16/20).결론 십이지장경검화경하활조직검사진단민감도교고,시진단십이지장유두부종류유교고개치적방법.
Objective To observe the diagnosis of duodenal papilla tumor. Methods Clinical material of preoperative imaging、endoscopic examination and final post-operative pathologic diagnosis in 25 patients with tumor of the major duodenal papilla were included. Results The detection rate of the papillary mass in 20 duodenoscopic appearance was 80% , meanwhile the detection rate in 25 ultrasound(US) and 13 computed(CT) were 32% and 23%. The detection rate between duodenoscopic appearance and US or CT was significantly different( P>0.01 ). The duodenoscopic biopsy had a diagnostic accuracy rate of 80% and a false-negative rate of 20%. Conclusion Duodenoscopic appearance and duodenoscopic biopsy are of great value for the diagnosis of duodenal papilla tumor.