原发性小肠腺癌50例临床分析

Clinical analysis of 50 patients with adenocarcinoma of the small bowel

目的对原发性小肠腺癌的临床特征进行分析,以提高疗效。方法对50例原发性小肠腺癌患者进行回顾性研究,分析其临床表现、治疗模式、预后因素及生存情况等。结果大多数小肠腺癌原发于十二指肠(74%)。临床表现主要为腹痛、腹部肿块、黄疸、黑便。21例患者行根治性手术(42%)。中位生存期为16个月,5年生存率为32.8%。单因素分析显示,只有手术方式对生存率的影响有统计学意义(P<0.0001)。结论原发性小肠腺癌多好发于十二指肠,临床表现缺乏特异性。手术仍然是治疗原发性小肠腺癌的主要手段,对无远处转移者应争取行根治术。

Objective：The objective of this study was to analyse the clinical characteristics to improve therapeutic effect. Methods：In the current study, the records of 50 patients with small bowel adenocarcinoma were reviewed retrospectively for clinical presentation, treatment modalities, prognostic factors, and survival. Results：Most tumors originated in the duodenum （74%）. Clinical presentation included abdominal pain, abdominal mass, obstruction of biliary tract, and melena. Cancer-directed surgery was performed in 21 （42%） patients. The median overall survival time was 1.6 months. The 5-year overall survival rate was 32. 8%. Only cancer-directed surgery was significantly associated with overall survival by univariate analysis （ P 〈 0. 000 1 ）. Conclusion ： SBA is found most commonly in the duodenum, and it is lack of specific clinical presentation. Surgery is the most effective therapy for SBA, and cancer-directed surgery should be taken for patients with nonmetastatic disease.