Williamson James Matthew Lloyd, Williamson Robin Charles Noel
J Med Assoc Thai. 2014 Jan;97(1):126-37.
Despite comprising at least 75% of the length of the gastrointestinal tract, the small bowel only accounts for 3 to 6% of all its neoplasms. Forty different tumor subtypes arise from the small bowel; the commonest is adenoma, and malignant lesions include gastrointestinal stromal tumor neuroendocrine tumor lymphoma, and adenocarcinoma. Small bowel tumors typically cause either non-specific symptoms or none at all, which explains both the frequent delay in diagnosis and the wide range of potential investigations. The relative inaccessibility of the small bowel to endoscopic assessment is being challenged by the increased use of both capsule and double balloon endoscopy. Advances in endoscopic assessment are mirrored by improved sensitivity of radiological and nuclear imaging. Operative resection provides the mainstay of treatment for malignant disease (and symptomatic benign lesions), with oncological agents and somatostatin analogues providing useful adjuncts for inhibiting tumor growth and relieving symptoms. Survival reflects underlying tumor subtype, but is generally poor for malignant disease.
尽管小肠长度至少占胃肠道的75%，但其肿瘤仅占所有胃肠道肿瘤的3%至6%。小肠可发生40种不同的肿瘤亚型；最常见的是腺瘤，恶性病变包括胃肠道间质瘤、神经内分泌肿瘤、淋巴瘤和腺癌。小肠肿瘤通常引起非特异性症状或根本没有症状，这既解释了诊断经常延迟的原因，也说明了潜在检查范围广泛的原因。胶囊内镜和双气囊内镜使用的增加对小肠难以进行内镜评估提出了挑战。内镜评估的进展与放射学和核成像敏感性的提高相呼应。手术切除是恶性疾病（以及有症状的良性病变）治疗的主要手段，肿瘤药物和生长抑素类似物为抑制肿瘤生长和缓解症状提供了有用的辅助手段。生存率反映了潜在的肿瘤亚型，但恶性疾病的总体生存率通常较低。
