小肠原发性恶性肿瘤72例临床分析

1984～1999年山东省肿瘤医院收治的72例小肠原发性恶性肿瘤患者的临床资料进行回顾性分析。肿瘤部位和手术方式。结果提示,20例行Χ线胃肠钡剂造影检查,诊断准确率达80%。腺癌1、3、5年生存率分别为53.3%(16/30)、26.7%(8/30)和13.3%(4/30);平滑肌肉瘤1、3、5年生存率分别为85.7%(24/28)、71.4%(20/28)和42.9%(12/28);恶性淋巴瘤1、3、5年生存率分别为40.0%(4/10)、20.0%(2/10)和0(0/10)。十二指肠肿瘤1、3、5年生存率分别为66.7%(12/18)、33.3%(6/18)和0(0/18);空肠肿瘤1、3、5年生存率分别为85.7%(24/28)、57.0%(16/28)和42.9%(12/28);回肠肿瘤1、3、5年生存率分别为53.8%(14/26)、30.8%(8/26)和15.4%(4/26)。根治性切除术后1、3、5年生存率分别为80.0%(32/40)、65.0%(26/40)和45.0%(18/40),姑息性切除术后1、3、5年生存率分别为50.0%(8/16),37.5%(6/16)和12.5%(2/16)。回顾分析结果提示,Χ线胃肠钡剂检查是最有价值的诊断方法。根治性手术是最有效的治疗手段。影响小肠原发性恶性肿瘤患者预后的因素有组织学类型、肿瘤部位和手术方式。

Clinical analysis of malignant tumor of the small bowel :a report of 72 cases

We studied 72 cases of primary malignant t um ors of the small bowel during 1984 to 1999 retrospectively and analyzed them by SPSS software. The factors including histological type, tumor site and type of resection were selected into Cox-model in survival analysis. RESULTS 20 c ases performed gastrointestinal barium media x-ray contrast examination ,with a n accurate diagnostic rate of 80.0%. The 1,3 and 5 year survival of adenocarcin oma is 55.3%(16/30),26.7%(8/30) and 13.3%(4/30);while Leiomysarcoma is 85.7% (24/28),71.4%(20/28) and42.9%(12/28);Lymphoma is 40.0%(4/10),20.0(2/10) and 0(0/10) respectively. The1, 3, and 5 year survival rate of duodenal tumor is 66 .7%(12/18), 33.3%(6/18) and 0%(0/18);jejunal tumor is 85.7%(24/28),57.0%(~1 6/28 ) and 42.9%(12/18);while that for ileal tumor is 53.8%(14/26),30.8%(8/2 6) and 15.4%(4/26) respectively. The 1,3 and 5 year survival rate after radical resection is 80.0%(32/40), 65.0%(26/40) and 45.0%(~18/40 ), while that for palliative resection is 50.5%(8/16),37.5%(6/16) and 12.5%(2/16) respectively . CONCLUSION For primary malignant tumors of the small bowel, gastrointestinal barium opaque meal roentgenography is the most valuable method for diagnosis , and surgical radical resection is the most effective therapy. The significant prognostic factors are histological type ,tumor site and type of resection.