十二指肠大乳头瘤的形态学特征

O. Usenko, V. Kropelnytskyi, V. Shkarban, K. Tumasova, O. Pidopryhora
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目标。沙利莫夫国家外科与移植研究所病理解剖与细胞学部自体材料上十二指肠大乳头恶性肿瘤形态学特征的研究。材料和方法。本研究纳入82例患者,于2019 - 2021年行胰十二指肠切除术治疗十二指肠大乳头恶性肿瘤,并进一步对切除标本进行形态学分析。患者平均年龄为(61.1±8.1)岁。结果。肿瘤有8种组织学类型,以胰胆管腺癌和肠腺癌最为常见。对这两种变体进行比较。年龄和性别差异无统计学意义(p < 0.05),但组织学分化程度和肿瘤扩散差异有统计学意义(p < 0.05),分别为0.039和0.003。因此,胰胆管型腺癌中低分化水平(G3)肿瘤的发生率分别为肠型腺癌的22.9%和11.8%,是肠型腺癌的1.9倍,肿瘤的扩散率为2.8倍(рТ3а -Т3b),分别为65.7和23.5%。胰胆管型腺癌患者区域淋巴结阳性的发生率为57.1%,高于肠型腺癌患者的44.1%。结论。十二指肠大乳头恶性肿瘤-一组异质性肿瘤。胰胆管和肠道类型的腺癌是最常见的。胰胆管腺癌作为一种组织学类型,比肠腺癌更具侵袭性。
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Morphological characteristics of the duodenal papilla magna tumors
Objective. Studying of morphological characteristics of the duodenal papilla magna malignant tumors on the own material of the Division of Pathological Anatomy and Cytology of the Shalimov National Institute of Surgery and Transplantology. Materials and methods. Into the investigation 82 patients were included, to whom pancreaticoduodenectomy was performed for duodenal papilla magna malignant tumors in 2019 – 2021 yrs with further conduction of morphological analysis of the specimen excised. The average age of the patients have constituted (61.1 ± 8.1) yrs old. Results. There were revealed 8 histological types of the tumors, most frequent of them – adenocarcinomas of pancreatobiliary and intestinal types. These two variants were compared. They did not differ for the age and gender (р>0,05), but statistically significantly differed for the histological differentiation degree and tumoral spread: р =0.039 and р = 0.003, accordingly. Thus, in the pancreatobiliary type of adenocarcinoma the tumors with low differentiation level (G3) were in 1.9 times more frequent, than in adenocarcinomas of intestinal type: 22.9 and 11.8%, and in 2.8 times more frequently the more spread tumors were revealed (рТ3а–Т3b): 65.7 and 23.5%, accordingly. As well, in the patients with adenocarcinomas of pancreatobiliary type a positive status of regional lymph nodes was revealed more frequently – in 57.1%, than in patients with adenocarcinomas of intestinal type – 44.1%. Conclusion. Duodenal papilla magna malignant tumors – a heterogeneous group of tumors. Adenocarcinomas of pancreatobiliary and intestinal types are the most prevalent. Pancreatobiliary adenocarcinoma, as a histological type, is more aggressive, than intestinal adenocarcinoma.
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