Carcinoid tumors of the duodenum. A clinicopathologic study of 99 cases.
Carcinoid tumors of the duodenum. A clinicopathologic study of 99 cases.
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十二指肠类癌。
DOI：
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发表时间：
1990
影响因子：
4.6
通讯作者：
E. B. Helwig
中科院分区：
文献类型：
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作者：
A. Burke;L. Sobin;B. Federspiel;K. Shekitka;E. B. Helwig
本文研究了99例十二指肠类癌。77例患者平均随访65个月，20例肿瘤为尸检结果，2例患者无法进行随访。16例肿瘤（21%）发生转移，均为最初发现; 3例患者（4%）死于转移性疾病（平均生存期，术后37个月）。与转移风险相关的特征是固有肌层受累，尺寸大于2 cm，以及存在核分裂像。对于51例肿瘤，免疫组化生长抑素与腹泻、胆石症或糖尿病（生长抑素综合征）病史之间无相关性。5例肿瘤与Zollinger-Ellison综合征相关，并具有免疫组化胃泌素，但在其他肿瘤中，溃疡病与胃泌素阳性之间没有相关性。十二指肠类癌是无痛性的，尤其是当它很小并且局限于粘膜下层时。生长抑素和胃泌素的免疫组化鉴定几乎没有临床意义。
Ninety-nine carcinoid tumors of the duodenum were studied. Seventy-seven patients were followed up for a mean period of 65 months, 20 tumors were autopsy findings, and two patients were unavailable for follow-up. Sixteen tumors (21%) produced metastases, all discovered initially; 3 patients (4%) died from metastatic disease (mean survival, 37 months postoperatively). Features associated with metastatic risk were involvement of muscularis propria, size greater than 2 cm, and the presence of mitotic figures. For 51 tumors, there was no correlation between immunohistochemical somatostatin and history of diarrhea, cholelithiasis, or diabetes mellitus (somatostatin syndrome). Five tumors were associated with Zollinger-Ellison syndrome and had immunohistochemical gastrin, but in the others there was no correlation between ulcer disease and gastrin positivity. Duodenal carcinoids are indolent, especially when small and localized to the submucosa. Immunohistochemical identification of somatostatin and gastrin has little clinical relevance.