Clinical Analysis Of Primary Small Intestinal Malignant Tumor:A Report Of 110 Cases

BCCKGROUND The length of small bowel is 70%-80% in the gastrointestinal tract of human body, but the primary small intestinal malignant tumor is rare that accounts for only 1%-3% of all tumors of the gastrointestinal tract. The clinical symptoms of primary intestinal malignant tumor have no specificity. Even though the modern imaging and endoscopic technology has got great development, but the detection rate of small intestinal malignant tumor in early stage is still low and misdiagnosis rate is high. The prognosis of small intestinal malignant tumor is poor and the mortality is high. The effect of adjuvant therapy is not exact and we don’t have standard chemotherapy regimens. We retrospectively analyzed a total of 110 cases of primary small intestinal malignant tumor identified in the department of primary surgery of Qilu hospital from 2004 to 2014. Tumors in the papilla of duodenum and ileocecal region are excluded. We do this research aiming to evaluate the clinical symptoms、etiology、treatment prognosis and improve the preoperative diagnosis and therapy after surgery. METHODS Retrospective analyses were conducted for the clinical data of 110 small intestinal malignant tumors, including sex, age, clinical symptoms, imaging test, treatment,the location of tumors, pathological types etc. RESULTS The clinical symptoms of intestinal malignant tumors are not typical. The disease course before visiting doctor is 1.5 days to 2555 days.56 cases of patient are male and the ratio of male-female is 1.04:1. The major clinical symptoms included abdominal pain, abdominal mass, anemia, gastrointestinal bleeding etc. The cases of suspected diagnosis are 69 through abdominal CT, MRI, and ultrasound.36 cases were diagnosed small intestinal malignant tumors through small bowel enteroscopy and capsule endoscopy. The most common tumor locations were jejunum, and then duodenum、ileum. The most common pathological types was stromal tumor, followed by adenocarcinoma, lymphoma etc. CONCLUSIONS The morbidity of primary intestinal malignant tumor is rare and lacking of typical symptoms and signs. The main symptoms are abdominal pain、abdominal mass、 gastrointestinal bleeding and anemia etc. The common tumor location is jejunum and common pathological type is stromal tumors. Even though we have not specific examination for small intestinal tumor, but the development of imageology and occurrence of small bowel enteroscopy and capsule endoscopy have improved the detection rate of small bowel tumors. Surgical resection is still the main method of treatment. We do not have positive research about chemotherapy and standard chemotherapy regimens. When we gave chemotherapy to patients suffering small intestinal malignant tumors, we often consulted colorectal cancer or gastric cancer. There is still controversy about whether adjuvant therapy after surgery can prolong the survival time of patients. In conclusion, the patients are likely to get cured if they are diagnosed early. There are lots of factors affecting the prognosis of small intestinal malignant tumor, but the recurrence and metastasis can be fatal. It is very important to explore standard treatment and it needs our further study.