小肠原发性恶性肿瘤

Primary Malignant Tumors of the Small Bowel

报告64例小肠原发性恶性肿瘤,男性33人,女性31人,平均年龄53.6岁。最常见症状为腹痛(68.8％)和腹部肿块(62.5％),部分有肠梗阻、肠出血、肠穿孔、腹膜炎和梗阻性黄疽。术前确诊率为65.6％。其中癌34例,肉瘤30例。腺癌占50％,其次为恶性淋巴瘤28.1％、平滑肌肉瘤15.6％、神经纤维肉瘤3.1％、类癌1.6％和十二指肠溃疡癌变1.6％。发生部位为十二指肠(29例)、空肠(20例)和回肠(15例)。发生广泛转移占65.6％。随访50例的5a生存率为16％。

64 cases of primary malignant tumor of the small bowel are reported in this paper. Thirty-three men and thirty-one women ranged from 20 to 82, with an average of 53. 6 years old. The chief symptom was abdominal pain (68. 8%)and mass(62.5%). Some pa- tients presented with complications of intestinal obstruction, bleeding, perforation, peritonitis and obstructive jaundice. Preoperative diagnosis was suspected in 42 cases (65. 6%). In this series, 34 cases were cancer and 30 cases were sarcoma. Adenocarcinoma was the most com- mon tumor (50%), followed by malignant lymphoma (28.1%), leiomyosarcoma (15.6%), neurofibrosarcoma (3. 1%), carcinoid tumor (1. 6%) and duodenal ulcer with malignant change (1.6%). The duodenum(29/64) was the most common site of malignancy, fol- lowed by jejunum (20/64) and ileum (15/64). Metastasis are frequent in most cases (65.6%). The 5 year postoperated survival rate in 50 cases was 16%.