原发性小肠恶性肿瘤的诊治研究进展
摘要
小肠是消化系统最重要的组成部分,因其存在范围广、发病隐匿、临床表现缺乏特异性症状及可靠诊断方法,常导致该类疾病诊断困难、漏诊率高。近年来,原发性小肠恶性肿瘤在人群中的发病率呈逐年升高趋势。尽管目前各种肿瘤诊疗方法不断发展,但因原发性小肠恶性肿瘤起病隐匿、临床早期表现缺乏特异性,故其诊断仍存在较大困难,治疗效果也较差。随着电子计算机断层扫描(CT)仿真内镜和双气囊内镜、胶囊内镜、腹腔镜、十二指肠镜及小肠气钡双重造影等检查的应用,极大地提高了原发性小肠恶性肿瘤的诊断率。目前临床上原发性小肠恶性肿瘤治疗一般包括手术、术后化学治疗、放射治疗、靶向药物治疗等,但目前手术治疗仍是最有效的治疗方法。
引文
[1] Tran TB, Qadan M, Dua MM, et al. Prognostic relevance of lymph node ratio and total lymph node count for small bowel adenocarcinoma[J]. Surgery, 2015, 158(2):486-493.
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[5] Hu Y, Lu X, Luo G. Effect of Recql5 defciency on the intestinal tumor susceptibility of Apcminmice[J]. World J Gastroenterol, 2010, 16(12):1482-1486.
[6] Heverhagen AE, Legrand N, Wagner V, et al. Overexpression of microRNA miR-7-5p is a potential biomarker in neuroendocrine neoplasms of the small intestine[J]. Neuroendocrinology, 2018, 106(4):312-317.
[7] Zhang Y, Zulfiqar M, Bluth MH, et al. Molecular diagnostics in the neoplasms of small intestine and appendix:2018update[J]. Clin Lab Med, 2018, 38(2):343-355.
[8]周克忠. 39例原发性小肠肿瘤诊治体会[J].数理医药学杂志, 2015, 28(3):382-383.
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[11] Soyer P, Boudiaf M, Fishman EK, et al. Imaging of malignant neoplasms of the mesenteric small bowel:new trends and perspectives[J]. Crit Rev Oncol Hematol, 2011, 80(1):10-30.
[12] Li X, Gui Y, Shen F, et al. The application value of capsule endoscopy in diagnosing small intestinal carcinoma[J]. J Cancer Res Ther, 2018, 14(1):57-60.
[13]周涛,刘振翠. CT仿真内镜对原发性小肠恶性肿瘤的诊断价值[J].中国医药导报, 2015, 12(5):130-132.
[14]陈庆民,汤庆超,王锡山.小肠肿瘤诊治的基础与临床研究进展[J/OL].中华结直肠疾病电子杂志, 2015, 4(5):530-532[2018-05-03]. http://zhjzcjbdzzz.yiigle.com/CN119324201505/1068863.htm.
[15]张庆华,李燕萍. B超联合腹部平片在急性小肠梗阻诊治中的价值[J].中国处方药, 2016, 14(9):136-137.
[16]邵淑琳,陈雪,肖鲁瑶,等.使用新型鼻胃导管向小肠内引入空气介质进行小肠CT仿真内镜检查的研究[J].中国临床医生杂志, 2016, 44(8):34-37.
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[19] Li X, Gui Y, Shen F, et al. The application value of capsule endoscopy in diagnosing small intestinal carcinoma[J]. J Cancer Res Ther, 2018, 14(1):57-60.
[20]中华医学会消化内镜学分会.中国胶囊内镜临床应用指南[J].中华消化内镜杂志, 2014, 31(10):549-551.
[21] Kameda C, Miwa H, Kawabata R, et al. Laparoscopic resection of a jejunal inflammatory fibroid polyp that caused occult gastrointestinal bleeding, diagnosed via capsule endoscopy and double-balloon enteroscopy:a case report[J].Clin Endosc, 2018, 51(4):384-387.
[22]李磊,沈燕如.胶囊内镜研究进展[J].中华实用诊断与治疗杂志, 2016, 30(2):108-110.
[23]张俊勇,张福奎,张澍田.内镜家族中的新成员——胶囊内镜[J].临床误诊误治, 2005, 18(4):249-250.
[24] Liangpunsakul S, Maglinte DD, Rex DK. Comparison of wireless capsule endoscopy and conventional radiologic methods in the diagnosis of small bowel disease[J]. Gastronintest Endosc Clin N Am, 2004, 14(1):43-50.
[25] Girelli CM, Porta P, Colombo E, et al. Development of a novel index to discriminate bulge form mass on smallbowel capsule endoscopy[J]. Gastrointest Endosc, 2011,74(5):1067-1074.
[26]李家玉.小肠癌1例报告并文献复习[D].兰州:兰州大学, 2015:24-27.
[27]李联杰,尹合坤,李启祥.双气囊小肠镜确诊的原发小肠肿瘤临床病理分析[J].中国实用医药, 2016, 11(33):23-25.
[28]陈飞,刘文天,张洁,等.胶囊内镜和双气囊内镜诊断小肠肿瘤及克罗恩病316例[J].世界华人消化杂志, 2011,19(2):200-204.
[29]罗永香,郑达武,吴培生,等.腹腔镜结直肠癌切除中转开腹手术14例临床分析[J].中华实用诊断与治疗杂志,2010, 24(11):1133-1134.
[30] Nishimura N, Mizuno M, Shimodate Y, et al. the role of double-balloon enteroscopy in the diagnosis and surgical treatment of metastatic small bowel tumors[J]. Intern Med, 2018, 57(9):1209-1212.
[31]杨清水,王万川,檀谊洪.腹腔镜辅助用于小肠肿瘤切除术的临床价值[J].中国现代医药杂志, 2011, 13(6):40-42.
[32]潘桂兰,黄春红.血清相关肿瘤标记物联合检测对消化道恶性肿瘤的临床价值研究[J].国际检验医学杂志,2015, 36(11):1537-1539.
[33] Nai Q, Ansari M, Liu J, et al. Primary small intestinal angiosarcoma:epidemiology, diagnosis and treatment[J]. J Clin Med Res, 2018, 10(4):294-301.
[34] Kokosis G, Ceppa EP, Tyler DS, et al. Laparoscopic duodenectomy for benign nonampullary duodenal neoplasms[J].Surg Laparosc Endosc Percutan Tech, 2015, 25(2):158-162.
[35]黄鹏,熊茂明.小肠恶性肿瘤诊断及治疗进展[J].中华实用诊断与治疗杂志, 2012, 26(8):729-731.
[36] Lee JH, Han HS, Kim YW, et al. Laparoscopic wedge resection with handsewn closure for gastroduodenal tumors[J]. J Laparoendosc Adv Surg Tech A, 2003, 13(6):349-353.
[37] Cangemi DJ, Patel MK, Gomez V, et al. Small bowel tumors discovered during double-balloon enteroscopy:analysis of large prospectively collected single-center database[J]. J Clin Gastroenterol, 2013, 47(9):769-772.
[38] Bedirli A, Salman B, Nasirov M, et al. A novel technique for duodenal resection and primary anastomosis with robotic assistance and orvil[J]. JSLS, 2017, 21(1):e2016.
[39] Kwekkeboom DJ, de Herder WW, Kam BL, et al. Treatment with the radiolabeled somatostatin analog[177 LuDOTA 0, Tyr3] octreotate:toxicity, efficacy, and survival[J]. J Clin Oncol, 2008, 26(13):2014-2130.
[40] Mao XN, Lu ZM, Wen F, et al. Bare-metal stents across the Vater's ampulla is a safe method for patients with lower bile duct obstruction[J]. Medicine(Baltimore), 2017, 96(45):e7475.
[41] Falcone R, Roberto M, Filetti M, et al. Anti epidermal growth factor receptor therapy in small bowel adenocarcinoma:case report and literature review[J]. Medicine(Baltimore),2018, 97(3):e9672.
[2]陶超超,王燕华,赵春雷,等.18F-FDG PET/CT显像在原发性小肠肿瘤中的诊断价值[J].中国临床医学影像杂志,2014, 25(11):787-792.
[3] Bednarczuk T, Bolanowski M, Zemczak A. Neuroendocrine neoplasms of the small intestine and appendix-management guidelines(recommended by the Polish Network of Neuroendocrine Tumours)[J]. Endokrynol Pol, 2017, 68(2):223-236.
[4]布小玲,沙卫红,刘婉薇,等.原发性小肠肿瘤211例临床分析[J].广东医学, 2010, 31(10):1331-1333.
[5] Hu Y, Lu X, Luo G. Effect of Recql5 defciency on the intestinal tumor susceptibility of Apcminmice[J]. World J Gastroenterol, 2010, 16(12):1482-1486.
[6] Heverhagen AE, Legrand N, Wagner V, et al. Overexpression of microRNA miR-7-5p is a potential biomarker in neuroendocrine neoplasms of the small intestine[J]. Neuroendocrinology, 2018, 106(4):312-317.
[7] Zhang Y, Zulfiqar M, Bluth MH, et al. Molecular diagnostics in the neoplasms of small intestine and appendix:2018update[J]. Clin Lab Med, 2018, 38(2):343-355.
[8]周克忠. 39例原发性小肠肿瘤诊治体会[J].数理医药学杂志, 2015, 28(3):382-383.
[9]刘哲峰,焦顺昌,杨俊兰,等.原发性小肠恶性肿瘤120例临床研究[J].南方医科大学学报, 2010, 30(3):602-604;607.
[10]唐洪渠,刘津,武粟,等.多层螺旋CT在原发性小肠淋巴瘤和小肠腺癌中的表现及价值[J].中国当代医药, 2017,24(9):89-91.
[11] Soyer P, Boudiaf M, Fishman EK, et al. Imaging of malignant neoplasms of the mesenteric small bowel:new trends and perspectives[J]. Crit Rev Oncol Hematol, 2011, 80(1):10-30.
[12] Li X, Gui Y, Shen F, et al. The application value of capsule endoscopy in diagnosing small intestinal carcinoma[J]. J Cancer Res Ther, 2018, 14(1):57-60.
[13]周涛,刘振翠. CT仿真内镜对原发性小肠恶性肿瘤的诊断价值[J].中国医药导报, 2015, 12(5):130-132.
[14]陈庆民,汤庆超,王锡山.小肠肿瘤诊治的基础与临床研究进展[J/OL].中华结直肠疾病电子杂志, 2015, 4(5):530-532[2018-05-03]. http://zhjzcjbdzzz.yiigle.com/CN119324201505/1068863.htm.
[15]张庆华,李燕萍. B超联合腹部平片在急性小肠梗阻诊治中的价值[J].中国处方药, 2016, 14(9):136-137.
[16]邵淑琳,陈雪,肖鲁瑶,等.使用新型鼻胃导管向小肠内引入空气介质进行小肠CT仿真内镜检查的研究[J].中国临床医生杂志, 2016, 44(8):34-37.
[17]丁重阳,李天女.18F-FDG PET/CT诊断小肠恶性肿瘤的价值[J].中国医学影像学杂志, 2015, 23(1):19-22.
[18] Van Weyenberg SJ, Meijerink MR, Jacobs MA, et al. MR enteroclysis in the diagnosis of small-bowel neoplasms[J].Radiology, 2010, 254(3):765-773.
[19] Li X, Gui Y, Shen F, et al. The application value of capsule endoscopy in diagnosing small intestinal carcinoma[J]. J Cancer Res Ther, 2018, 14(1):57-60.
[20]中华医学会消化内镜学分会.中国胶囊内镜临床应用指南[J].中华消化内镜杂志, 2014, 31(10):549-551.
[21] Kameda C, Miwa H, Kawabata R, et al. Laparoscopic resection of a jejunal inflammatory fibroid polyp that caused occult gastrointestinal bleeding, diagnosed via capsule endoscopy and double-balloon enteroscopy:a case report[J].Clin Endosc, 2018, 51(4):384-387.
[22]李磊,沈燕如.胶囊内镜研究进展[J].中华实用诊断与治疗杂志, 2016, 30(2):108-110.
[23]张俊勇,张福奎,张澍田.内镜家族中的新成员——胶囊内镜[J].临床误诊误治, 2005, 18(4):249-250.
[24] Liangpunsakul S, Maglinte DD, Rex DK. Comparison of wireless capsule endoscopy and conventional radiologic methods in the diagnosis of small bowel disease[J]. Gastronintest Endosc Clin N Am, 2004, 14(1):43-50.
[25] Girelli CM, Porta P, Colombo E, et al. Development of a novel index to discriminate bulge form mass on smallbowel capsule endoscopy[J]. Gastrointest Endosc, 2011,74(5):1067-1074.
[26]李家玉.小肠癌1例报告并文献复习[D].兰州:兰州大学, 2015:24-27.
[27]李联杰,尹合坤,李启祥.双气囊小肠镜确诊的原发小肠肿瘤临床病理分析[J].中国实用医药, 2016, 11(33):23-25.
[28]陈飞,刘文天,张洁,等.胶囊内镜和双气囊内镜诊断小肠肿瘤及克罗恩病316例[J].世界华人消化杂志, 2011,19(2):200-204.
[29]罗永香,郑达武,吴培生,等.腹腔镜结直肠癌切除中转开腹手术14例临床分析[J].中华实用诊断与治疗杂志,2010, 24(11):1133-1134.
[30] Nishimura N, Mizuno M, Shimodate Y, et al. the role of double-balloon enteroscopy in the diagnosis and surgical treatment of metastatic small bowel tumors[J]. Intern Med, 2018, 57(9):1209-1212.
[31]杨清水,王万川,檀谊洪.腹腔镜辅助用于小肠肿瘤切除术的临床价值[J].中国现代医药杂志, 2011, 13(6):40-42.
[32]潘桂兰,黄春红.血清相关肿瘤标记物联合检测对消化道恶性肿瘤的临床价值研究[J].国际检验医学杂志,2015, 36(11):1537-1539.
[33] Nai Q, Ansari M, Liu J, et al. Primary small intestinal angiosarcoma:epidemiology, diagnosis and treatment[J]. J Clin Med Res, 2018, 10(4):294-301.
[34] Kokosis G, Ceppa EP, Tyler DS, et al. Laparoscopic duodenectomy for benign nonampullary duodenal neoplasms[J].Surg Laparosc Endosc Percutan Tech, 2015, 25(2):158-162.
[35]黄鹏,熊茂明.小肠恶性肿瘤诊断及治疗进展[J].中华实用诊断与治疗杂志, 2012, 26(8):729-731.
[36] Lee JH, Han HS, Kim YW, et al. Laparoscopic wedge resection with handsewn closure for gastroduodenal tumors[J]. J Laparoendosc Adv Surg Tech A, 2003, 13(6):349-353.
[37] Cangemi DJ, Patel MK, Gomez V, et al. Small bowel tumors discovered during double-balloon enteroscopy:analysis of large prospectively collected single-center database[J]. J Clin Gastroenterol, 2013, 47(9):769-772.
[38] Bedirli A, Salman B, Nasirov M, et al. A novel technique for duodenal resection and primary anastomosis with robotic assistance and orvil[J]. JSLS, 2017, 21(1):e2016.
[39] Kwekkeboom DJ, de Herder WW, Kam BL, et al. Treatment with the radiolabeled somatostatin analog[177 LuDOTA 0, Tyr3] octreotate:toxicity, efficacy, and survival[J]. J Clin Oncol, 2008, 26(13):2014-2130.
[40] Mao XN, Lu ZM, Wen F, et al. Bare-metal stents across the Vater's ampulla is a safe method for patients with lower bile duct obstruction[J]. Medicine(Baltimore), 2017, 96(45):e7475.
[41] Falcone R, Roberto M, Filetti M, et al. Anti epidermal growth factor receptor therapy in small bowel adenocarcinoma:case report and literature review[J]. Medicine(Baltimore),2018, 97(3):e9672.