目的 探討十二指腸腺瘤并大出血的診斷和治療。方法 對2例十二指腸腺瘤并大出血患者進行回顧性分析，并結合文獻進行討論。結果 2例術前均行X線氣鋇雙重造影、胃鏡及腫塊活檢，但未確診。2例均行十二指腸切開、腫瘤切除術而痊愈。結論 十二指腸腺瘤早期多無臨床癥狀，隨著腫瘤的增大可并發腸梗阻或腫瘤潰瘍出血而出現相應癥狀； X線鋇餐和胃鏡可發現腫瘤，但難于確診，經內窺鏡或十二指腸切開、腫瘤切除術是治療本病的常用方法。
Objective To study the expressions of SKP2 and p27 in gastric carcinoma and pericancerous tissues and to detect the relationship between their expressions and clinicopathological features. Methods Forty-nine cases of gastric carcinoma spicemen and 20 cases of tissue adjacent to the carcinoma were cut and made into paraffin-embedded slices. The expressions of SKP2 and p27 were then detected by SP immunohistochemical method. Results The positive expression rate and score of SKP2 were both significantly higher in the gastric carcinoma tissues than those in pericancerous tissues (P＜0.01), whereas those terms of p27 were higher in pericancerous tissues (P＜0.05, P＜0.01). It was observed that the pericancerous tissues with positive SKP2 expression or with negative p27 expression showed atypical hyperplasis ranging from moderate to severe degrees. The positive rate and score of SKP2 were significantly lower in the cases of infiltrating depth T1+T2， without-metastasis of lymph node, with-metastasis of the first site lymph node, and without-metastasis of distant organs than those in infiltrating depth T3+T4, with-metastasis of lymph node, with-metastasis of the second or third site lymph node and with-metastasis of distant organs in gastric carcinoma tissues (P＜0.05， P＜0.01), whereas the results were contrary for p27 (P＜0.01). There was a negative correlation between the score of SKP2 and that of p27 in gastric carcinoma tissues (r=-0.65, P＜0.01). Conclusion The expressions of SKP2 and p27 may act as important biological markers to reflect carcinogenesis, progression, biological beheviors and prognosis of gastric carcinoma.