原发性小肠肿瘤44例临床分析

Clinical Analysis of 44 Cases of Primary Small Intestinal Tumor

背景:原发性小肠肿瘤非常少见,临床早期诊断困难。目的:探讨原发性小肠肿瘤的临床常见表现、诊断和治疗方法。方法:回顾性分析1990年1月～2007年1月北京友谊医院确诊的44例原发性小肠肿瘤患者的临床资料。结果:原发性小肠肿瘤患者男女比例为3∶1。主要临床表现为柏油样便、腹部包块、腹痛和肠梗阻症状。原发性小肠肿瘤以空肠最为常见,良恶性比为1∶3.4。44例原发性小肠肿瘤患者中,29例(65.9%)为间质瘤,其中良性6例,低度恶性7例,高度恶性16例;5例(11.4%)为非霍奇金淋巴瘤;4例(9.1%)为腺癌;3例(6.8%)为平滑肌瘤;1例(2.3%)为平滑肌肉瘤;1例(2.3%)为类癌;1例(2.3%)为绒毛管状腺瘤。所有患者均行手术治疗。结论:原发性小肠肿瘤临床表现无特异性,病理类型多样,结合常见临床表现和有效检查方法有助于尽早诊断该病。

Background： Primary small intestinal tumor is rare and difficult to diagnose at its early stage. Aims： To investigate the clinical presentations, diagnosis and treatment of primary small intestinal tumor. Methods： Clinical data of 44 patients with primary small intestinal tumor admitted from Jan. 1990 to Jan. 2007 in Beijing Friendship Hospital were collected and analyzed retrospectively. Results： The ratio of primary small intestinal tumor in males and females was 3：1. The most common clinical presentations were tarry stools, abdominal mass, abdominal pain and symptoms of ileus. Most primary small intestinal tumors were located at jejunum. The ratio of benign and malignant tumors was 1：3.4. In 44 patients with primary small intestinal tumor, 29 （65.9%） were intestinal stromal tumors, of which 6 were benign, 7 were low grade malignancy and 16 were high grade malignancy; 5 （11.4%） non-Hodgkin lymphoma, 4 （9.1%） adenocarcinoma, 3 （6.8%） leiomyoma, 1 （2.3%） leiomyosarcoma, 1 （2.3%） carcinoid and 1 （2.3%） villous tubular adenoma. Surgery was performed in all patients. Conclusions： Primary small intestinal tumor has no specific symptoms but with various pathological patterns. A combination of frequent symptoms and effective methods of examination can be helpful for the early diagnosis of primary small intestinal tumor.