Zhang W L
First Hospital, Zhongshan University of Medical Sciences, Guangzhou.
Zhonghua Zhong Liu Za Zhi. 1988 Sep;10(5):370-2.
102 patients with primary tumors of the small intestine proved by pathology in our hospital from 1964 to 1983 are reported. It made up 4% of primary gastrointestinal (GI) neoplasms during this period. Of the 102 patients, 32 were benign tumors, comprising 11.3% of all benign tumors of the GI tract. There were 70 malignant tumors, constituting 3.1% of all malignant tumors of the GI tract. Leiomyomas were very common in benign tumors while malignant lymphomas and carcinomas were predominant in malignant neoplasms. The main clinical manifestations were abdominal pain, mass, obstruction and GI hemorrhage. Eight patients were complicated with perforation, 6 of them were malignant tumors. Multiple lesions were found in 22 and 16 of them were malignant tumors. Only 29.3% of primary tumors of the small intestine could be demonstrated by barium X-ray examination. Correct diagnosis was made preoperatively in 13.7% of all patients. Resectability and operative mortality rates in malignant tumors were 70% and 12.9%, respectively, 62.3% of the patients were followed with an overall 5-year survival rate of 36.9% (malignant lymphoma 62.5% and leiomyosarcoma or carcinoma (18.2%). The 5-year survival rate was 43.8% after radical operation and 38.9% after palliative operation. The overall 10-year survival rate was 16.2%. One patient with lymphosarcoma is alive 21.5 years after operation. The reasons of the low incidence, the high misdiagnosis rate and the related aspects of diagnosis and treatment of this tumor are discussed.
本文报告了我院1964年至1983年间经病理证实的102例小肠原发性肿瘤患者。这占同期原发性胃肠道(GI)肿瘤的4%。在这102例患者中,32例为良性肿瘤,占胃肠道所有良性肿瘤的11.3%。有70例恶性肿瘤,占胃肠道所有恶性肿瘤的3.1%。平滑肌瘤在良性肿瘤中非常常见,而恶性淋巴瘤和癌在恶性肿瘤中占主导地位。主要临床表现为腹痛、肿块、梗阻和胃肠道出血。8例患者并发穿孔,其中6例为恶性肿瘤。22例发现有多处病变,其中16例为恶性肿瘤。小肠原发性肿瘤仅29.3%能通过钡剂X线检查显示。所有患者中术前正确诊断率为13.7%。恶性肿瘤的可切除率和手术死亡率分别为70%和12.9%,62.3%的患者得到随访,总体5年生存率为36.9%(恶性淋巴瘤为62.5%,平滑肌肉瘤或癌为18.2%)。根治性手术后5年生存率为43.8%,姑息性手术后为38.9%。总体10年生存率为16.2%。1例淋巴肉瘤患者术后存活21.5年。本文讨论了该肿瘤发病率低、误诊率高的原因以及诊断和治疗的相关问题。