原发性小肠恶性肿瘤的治疗和预后(36例回顾性分析)

目的：研究小肠恶性肿瘤的临床特点以及决定预后的因素。方法：回顾性分析了我院１９７４年至１９９９年收治的３６例原发性恶性小肠肿瘤病例（不包括壶腹周围癌），其中以淋巴瘤居多，占４７．２％。临床症状无特异性，内镜和消化道钡餐检查是主要诊断手段。５０％的病例在手术时已有远处转移，仅１８例获根治性切除。结果：３０例成功地进行了随访。小肠恶性肿瘤患者术后５年生存率为４７．３％。Ｃｏｘ模型多因素分析显示，远处转移和肿瘤大小对生存率有显著影响。结论：早期诊断、早期治疗是提高小肠恶性肿瘤预后的主要手段，对无远处转移的病例应争取根治术。

Treatment and Prognosis of Primary Small Bowel Tumors: A Retrospective Study of 42 Cases.

Objective: To study the clinical manifestations of small bowel malignancies and factors influencing their prognosis. Methods: We retrospectively studied 36 cases of primary small bowel malignancies tumors(except periampullary tumors) admitted to our hospital from 1974 to 1999. Lymphoma(47.2%) were the commonest among all small bowel malignancies. There was no characteristic clinical sign for small bowel tumors, and endoscopy and GI are the main diagnostic methods used. About 50 percent of the patients had distal metastasis, and only 18 cases underwent radical resection. Results: Adequate follow-up were available in 36 cases. The overall 5-year survival rate of malignant small bowel tumors was 47.3%. Multivariate analysis(Cox methods) showed t hat metastasis and size of tumors were the factors influ- encing the 5-year survival rate. Conclusions: Early diagnosis and early treatment are key elements in improving the prognosis of malignant small bowel tumors. Radical resection should be performed in patients without metastasis.