原发性空回肠肿瘤临床病理分析

目的探讨原发性空、回肠肿瘤的临床表现、病理类型及其特点，为进一步提高对该类疾病的诊断水平提供临床经验。方法对2003年1月-2012年l1月62例原发性空、回肠肿瘤患者的临床资料进行回顾性分析。结果患者年龄（554-16）岁，〉40岁者占83．9％。良性肿瘤9例，恶性肿瘤53例，良、恶性之比为1：5．9。53例恶性肿瘤包括恶性间质瘤26例，恶性淋巴瘤15例，腺癌9例，另有平滑肌肉瘤、肉瘤样癌、滤泡树突状细胞肉瘤各l例；主要临床表现为腹痛（44／62，71．0％）、肠梗阻（22／62，35．5％）、贫血（16／62，25．8％）、腹胀不适（11／62，17．7％）、消化道出血（10／62，16．1％）、腹部包块（8／62，12．9％）。术前小肠肿瘤的诊断率仅为25．8％（16／62），46例患者经手术探查及术后病理检查得以确诊。结论原发性空、回肠肿瘤缺乏特异性临床表现，早期诊断相当困难，术前误诊率高，高度警惕和加深对该疾病的认识十分重要。

Clinicopathological Analysis of Primary Jejunoileal Neoplasm

Objective To analyze the clinical characteristics, pathologic types and features of primary jejunoileal neoplasms, in order to provide clinical experiences for further improvement in the diagnosis of this disease. Methods Clinical data of 62 patients with primary jejunoileal neoplasms between January 2003 and November 2012 were analyzed retrospectively. Results The average age of the patients was （55 ~： 16） years, and the age of 83.9% patients was over 40 years old. There were 9 benign and 53 malignant tumors in this series with a ratio of 1 ： 5.9. The 53 malignant tumors consisted of 26 malignant gastrointestinal stromal tumors, 15 malignant lymphomas, 9 adenocarcinomas, 1 leiomyosarcoma, 1 sarcomatoid carcinoma and 1 follicular dendritic cell sarcoma. Abdominal pain （44/62, 71.0%）, bowel obstruction （22/62, 35.5%）, anemia （16/62, 25.8%）, abdominal distension or discomfort （11/62, 17.7%）, hemorrhage （10/62, 16.1%） and abdominal mass （8/62, 12.9%） were the most frequent clinical features of primary jejunoileal tumors. Correct preoperative diagnosis rate of small intestinal neoplasms was only 25.8% （16/62）, and 46 patients were diagnosed by laparotomy examination and postoperative pathological study. Conclusions The early diagnosis for primary jejunoileal neoplasms is usually difficult because most of them have nonspecific clinical manifestations with a high rate of preoperative misdiagnosis. Maintaining a high degree of suspicion and recognizing the possibility of primary jejunoileal neoplasms are very important.