空回肠与结直肠肿瘤的临床内镜特征

Clinical and Endoscopic Characteristics of Patients with Jejunoileum Tumor or Colorectal Tumor

目的探讨空回肠肿瘤与结直肠肿瘤的临床及内镜特征,以提高对这两种部位肿瘤的认识。方法回顾性分析双气囊小肠镜检出的空回肠肿瘤及结肠镜检出的结直肠肿瘤的临床表现、病变部位、组织学类型及内镜下表现,并进行对比。结果小肠镜检查162例,检出空回肠肿瘤21例(13.0%,21/162);结肠镜检查7258例,共检出结直肠肿瘤349例(4.8%,349/7258)。空回肠肿瘤患者以小肠出血为主要症状95.2%(20/21)。21例肿瘤中病变位于空肠19例,回肠2例;检出间质瘤20例,腺癌1例。结直肠肿瘤患者以便血为首发症状51.9%(181/349)。349例肿瘤中病变位于直肠53.0%(185/349);检出腺癌330例(94.6%),淋巴瘤7例(2.0%),类癌6例(1.7%),间质瘤6例(1.7%)。癌、淋巴瘤、类癌、间质瘤的内镜下表现各不相同。结论空回肠肿瘤以空肠间瘤最多见。结直肠肿瘤以腺癌为主,且直肠为最好发部位。小肠镜、结肠镜结合病理检查是确诊空回肠及结直肠肿瘤的最有效方法。

Objective To investigate the clinical and endoscopic characteristics of patients with jejunoileum tumor or colorec- tal tumor,and improve the diagnostic levels. Methods The data of patients with jejunoileum tumor identified by double balloon endoscopy （DBE） and colorectal tumor by colonoscopy were studied retrospectively. The clinical manifestation, position, endoscop- ic expression and histological type were analyzed. Results Jejunoileum tumors were identified in 21 of 162 cases（ 13.0% ）, while eolorectal tumors were 349 of 7285 （4.8%）. Obscure gastrointestinal bleeding was the common clinical manifestation in ca- ses with jejunoileum tumor（95.2% ,20/21 ）. Tumors located in jejunum accounted for 90.5%. Stromal tumor was the most com- mon one,identified in 20 cases,whereas only 1 case has carcinoma. The bloody stool in cases with colorectal tumor accounted for 51.9%. Tumors located in rectum were 185 of 349 cases （ 53.0% ）. Colorectal carcinoma, lymphoma, carcinoid, stromal tumor were identified in 330,7,6 and 6 subjects, respectively. Colorectal carcinoma, lymphoma, carcinoid and stromal tumor show differ- ent characters in endoscope. Conclusion Stromal tumor localized in jejunum was the most common jejunoileum tumor. The most common colorectal tumor is adenocarcinoma and is mainly located in rectum. Endoscopy combined with pathology is the safest and most effective diagnostic method for subjects with jejunoileum tumor and colorectal tumor.