小肠原发性肿瘤33例临床分析

Clinical Analysis of 33 Cases of Primary Small Intestine Tumors

目的 :探讨小肠肿瘤临床特点和早期诊断手段。方法 :回顾性分析 33例原发性小肠肿瘤患者的临床资料。结果 :小肠良性肿瘤 5例均为平滑肌瘤 ;恶性肿瘤 2 8例 ,其中平滑肌肉瘤 13例 (4 6 4 % ) ,淋巴肉瘤 11例 (39 2 % ) ,腺癌 3例 (10 7% ) ,类癌 1例 (3 5 % )。临床上无特异性症状及可靠的诊断方法 ,内窥镜和全消化道钡餐造影是主要诊断手段。 5 3 6 %的恶性病例在手术时已有远处转移 ,仅 13例(4 6 4 % )行根治性切除。根治切除术后 5年生存率为 4 6 1%。结论 :早期诊断、早期治疗是提高小肠恶性肿瘤患者生存率的关键 ,对无远处转移者应争取行根治术。

Objective To study the clinical features and the ways of early diagnosis of small intestine tumors.Methods Analyse the clinical data of patients with primary small intestine tumors in 33 cases retrospectively.Results Five cases of this group's benign small intestine tumors were all leiomyoma;Twenty eight cases were malignant tumors.Among them,there were leiomyosarcoma in 13 cases (46 4%),malignant lymphoma in 11 cases (39 2%),adenocarcinoma in 3 cases (10 7%) and carcinoid in 1 case (3 5%).There were no characteristic clinical signs and reliable diagnostic methods in small intestine tumors.Endoscopy and whole alimentary tract barium meal were the main diagnostic methods.53 6% patients with malignancy was found distant metastasis during the operation,and radical resection was performed only in 13 cases (46 4%).After the radical resection,the overall 5 year survival rates were 46 1%.Conclusions Early diagnosis and treatment are a key for increasing the existence rate of patients with malignant tumors of small intestine. Radical resection should be done if no distant metastasis is found.