ĐẶC ĐIỂM DỊCH TỄ HỌC, NHIỄM HELICOBACTER PYLORI, LÂM SÀNG, CẬN LÂM SÀNG CỦA UNG THƯ DẠ DÀY PHỐI HỢP VỚI LOÉT TÁ TRÀNG (49 TRƯỜNG HỢP)

Abstract

Aim of study: 1. Evaluate the Epidemiology, Helicobacter pylori infection of gastric cancer coexistence with duodenal ulcer. 2. The clinical and paraclinical feature of gastriccancer associating with duodenal ulcer. Patients and method: + Retrospective study. + Time: 2020-2025. Result: - There were 49 patients, male 40 patients (83,3%), female 9 patients (18,7%). + Average age  63,74 ± 9,92 Y (from 42- 80 Y). + Residance: Rural area 79,6%;  Urban 20,4%; + Profession: Farmer 71,4%; Intellectuel 2,1%; Others 26,5%. - Medical history: Gastroduodenal ulcer 77,6%; Gastroduodenal ulcer perforation 8,2%; Gastro-Jejunostomy 6,1%; HP infection 20,4%. - Clinical Symptoms: Epigastric pain 97,9%; Melena and hematemesis 59,18%; Gastric outlet obstruction 36,7%; Palpable tumor  26,5%; Weight loss 71,4%. - Gastroduodenalscopy: Lower gastric cancer 42/49 patients (85,7%); Middle gastric cancer 7/49 patients (14,3%). + Anterior duodenal ulcer 15/49 patients (30,6%); Posterior duodenal ulcer 1 patient (2,04%); Kissing ulcer 3/49 patients (6,1%); No duodenal ulcer 7/49 patients (14,3%); No description of ulcer 15/49 patients (30,6%); Gastric outlet obstruction 11/49 patients (22,4%). - CTScan: Gastrictumor diameter ≤ 5 cm 27/49 patients (55,1 %); Gastric tumor > 5cm 3/49  (6,1%). No gastric tumor in 38,8%. - Histopathology: Moderately differentiated Adenocarcinome in 40,8%; Poorly diferentiated Adenocarcinoma in 38,8%. Signet Ring Cell Carcinoma (SRCC) in 20,4%. Conclusion: There were 49 gastriccancer associated with duodenal ulcer patients: The Epidemiology and Helicobacter.Pylori features: +Sex ratio: Male/female 4.44,Average age: 63,74 ± 9,92 Y (from 42- 80 Y); + Rural area  79,6%, Urban 20,4%; Farmer: 71,4%; Intellectuel: 2,1%; Others:26,5%. + Helicobacter Infection:+ HP  Test(+) 20,4%, HP Test (-) 34,7%, No test done 44,9%. + Medical history: Gastroduodenalulcer in 77,6%; Suture of duodenal ulcer perforation or gastrojejunostomy due to gastric outlet obstruction in 14,3%. Clinical and paraclinical features: - Clinical features: Epigastric pain 97,9%; Melena and hematemesis 59,18%; Gastric outlet obstruction 36,7%; palpable tumor  26,5%: weight loss 71,4%. - Laboratory test: Anemia in 42,85%; Elevated white cell counts > 10 (G/L) in 38,8%; White cell counts lower than 2 G/L  in 2,04%. + Platelets lower than 100 G/L in 6,1%; Platelets  about 100-150 G/L in 8,2%. - Gastroduodenal Scopy: + Lower gastric cancer 85,7%; Middle gastric cancer 14,3%. + Gastric tumor diameter ≤5 cm in 63,3%; More than >5 cm in 36,7%. + Anterior duodenal ulcer in 30,6%; Posterior duodenal ulcer in 2,04%; Kissing ulcer in 6,1%; No duodenal ulcer in 14,3%; No description of ulcer in 30,6%; Gastric outlet obstruction in 22,4%. - CTScan: Gastric tumor diameter ≤5 cm in 55,1%; More than >5 cm in 6,1%; No thickening of stomach  in 38,8%. -Histopathology: + Moderately  differentiated AC in  40,8%; Poorly diferentiated AC in 38,8%, Signet Ring Cell Carcinoma (SRCC) in 20,4%. + Duodenal ulcer in 89,8% (by intraoperation biopsy); Duodenal ulcer were diagnosed intraoperation in 10,2%.