小肠低分化神经内分泌癌的诊断与治疗

Diagnosis and treatment of poorly differentiated small intes- tinal neuroendocrine carcinoma

小肠神经内分泌癌是一类起源于弥散性神经内分泌系统的低分化高度恶性肿瘤，弥漫性表达神经内分泌分化的一般性标志物。该病表现为类癌综合征，但大多数患者起病隐匿且缺乏特异性临床表现，术前诊断较困难。2012年6月18日江苏省苏北人民医院收治1例因接受胶囊内镜检查导致胶囊滞留引起肠梗阻的患者。患者经手术治疗解除肠梗阻症状，术中发现远端小肠恶性病变，术后病理检查结果证实为回肠低分化神经内分泌癌伴转移。

Small intestinal neuroendocrine carcinoma is poorly differentiated, highly malignant, and originated from the diffuse neuroendocrine system. It diffusely expresses the general neuroendocrine differentiation markers. The disease can be manifested as carcinoid syndrome, but most of the patients were with occult onset and absence of specific clinical symptoms, which led to difficult diagnosis before operation. On June 18, 2012, a patient with manifestation of recurrent vague abdominal pain received capsule endoscopy at the Northern Jiangsu People＇s Hospital. The capsule endoscope was retained in the distal small intestine, and malignant ileum lesion was revealed during the surgical exploration. Finally, poorly differentiated neuroendocrine carcinoma with abdominal wall metastases was identified by pathological examination.