Introduction:Small bowel cancer is very rare; although the incidence of adenocarcinoma and other anatomopathological forms has increased recently, the diagnosis and treatment of this disease are still debatable because of the clinical heterogeneity and the absence of studies including a large number of patients.Materials and Methods:We performed a retrospective study over 10 years in which we analyzed the clinical, imaging, and anatomopathological data of 46 patients hospitalized in a surgery clinic and diagnosed with small bowel cancer (duodenum, jejunum, and ileum).Results:After clinical assessment of these patients, including complications (occlusion, bleeding, and perforation), the CT scan established the diagnosis in over 90% of the cases of the complicated form of the disease. Surgery has a curative role in localized cancers; tumor location, local invasion, the presence of locoregional lymph nodes, and the number of multiple tumors influence the type of surgery. The conventional pathological exam was completed via immunohistochemical staining. Adjuvant oncological treatment was performed after surgery (according to the guidelines); in patients with exceptional histopathological forms, the therapy was personalized.Conclusions:Most small bowel cancers were diagnosed with complications (occlusion and bleeding); the tumor type, location, and presence of multiple bowel cancers significantly influenced its management. Independently of the surgical resection (R0/R1 or R2), the prognosis of the disease depends on the tumor aggressivity, location (single/multiple), and locoregional node invasion.
引言：小肠癌极为罕见；尽管近年来腺癌及其他解剖病理类型的发病率有所上升，但由于临床异质性及缺乏大样本研究，该疾病的诊断与治疗仍存在争议。 材料与方法：我们开展了一项为期10年的回顾性研究，分析了46例外科临床收治的小肠癌（十二指肠、空肠及回肠）患者的临床、影像学及解剖病理学数据。 结果：通过对患者（包括并发症：梗阻、出血及穿孔）的临床评估，CT扫描对超过90%的复杂型病例实现了确诊。手术对局限性癌症具有根治作用；肿瘤位置、局部浸润程度、区域淋巴结转移情况以及多发性肿瘤数量均影响手术方式选择。常规病理检查通过免疫组化染色进行补充。术后根据指南实施辅助肿瘤治疗；对于特殊组织病理类型的患者，治疗方案实施个体化调整。 结论：多数小肠癌确诊时已伴发并发症（梗阻与出血）；肿瘤类型、位置及多发性特征显著影响临床决策。无论手术切除范围（R0/R1或R2），疾病预后均取决于肿瘤侵袭性、病灶分布（单发/多发）及区域淋巴结转移情况。
肿瘤(癌症)患者之家