原发性小肠恶性肿瘤的95例诊治分析  

Diagnosis and treatment of primary small bowel malignant tumor

作　　者：宋京翔[1] 张再重[1] 涂小煌[1] 林晨[1] 黎成金[1] 王烈[1] 

机构地区：[1]厦门大学附属东方医院,福建医科大学福总临床医学院,南京军区福州总医院普通外科,南京军区普通外科研究所,福州350025

出　　处：《腹部外科》2014年第2期130-132,共3页Journal of Abdominal Surgery

基　　金：福建省自然科学基金资助项目（C0410045、2013J01339）

摘　　要：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，其次为问质瘤、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。Objective To explore the elinieopathological characteristics and diagnosis and treat- ment of primary small bowel malignant tumor. Methods Retrospective analyses were conducted for the clinicopathological 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, gas- trointestinal 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 ~//00 （58/95）. And the mean survival time was 32 ＋- 15. 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.

关 键 词：肠肿瘤 诊断 治疗 分子靶向治疗 

分 类 号：R656.7[医药卫生—外科学]