原发性小肠恶性肿瘤的95例诊治分析

摘要

Objective To explore the clinicopathological characteristics and diagnosis and treatment of primary small bowel malignant tumor.Methods Retrospective analyses were conducted for the clini-copathological data of 95 primary small bowel malignant tumors.Results Adenocarcinoma was the most frequent malignant tumor followed by stromal tumor,lymphoma and carcinoid.The common clinical manifestations included abdominal pain,abdominal discomfort,abdomen mass,gastrointesti-nal hemorrhage,intestinal obstruction and jaundice,etc.All of them underwent operations with a preoperative diagnostic (R0)rate of 61 .1 % (58/95 ).The radical resection rate was 61 .1 % (58/95).And the mean survival time was 32 ±1 5.7 months during a follow- up period of 3 - 5 years. Conclusions The clinical manifestations of primary small intestinal malignant tumor are non-specific so that its early diagnosis remains rather difficult.The major diagnostic modality is computed tomo-graphy.Upon a definite diagnosis,timely treatment is essential.Targeted therapeutics plus surgery and chemotherapy may improve its outcomes.%目的：探讨原发性小肠恶性肿瘤的临床表现、病理特点及诊治方法。方法回顾性分析2000年1月至2009年12月间收治95例原发性小肠恶性肿瘤的临床、病理和随访资料。结果95例原发小肠恶性肿瘤中以腺癌最常见，其次为间质瘤、淋巴瘤和神经内分泌肿瘤。临床主要表现为非特异性腹痛、腹部不适、腹部肿块、消化道出血、肠梗阻、黄疸等。本组根治性(R0)切除率为61.1%(58/95)，术前诊断率为61.1%(58/95)，随访3~5年，平均存活期(32±15.7)个月。结论原发性小肠恶性肿瘤缺乏特异性临床表现，早期诊断困难，改善预后的关键在于早期诊断和治疗。CT 具有较好诊断价值，外科手术仍是唯一可获治愈的手段，化疗和分子靶向治疗在内的综合治疗也扮演了重要角色。