台東某區域醫院小腸原發性惡性腫瘤十一年之經驗

Primary Malignant Tumors of the Small Intestine 11-year Experience in a Regional Hospital in Taitung

李晉賢(Chin-Hsien Li) ； 白明忠(Ming-Jong Bair) ； 張文熊(Wen-Hsiung Chang) ； 林錫泉(Shee-Chan Lin) ； 陳志仁(Chih-Jen Chen) ； 廖文聖(Wen-Shen Liao)

《內科學誌》 18卷1期 (2007/02) Pp. 29-34

https://doi.org/10.6314/JIMT.2007.18(1).04

摘要

小腸的原發性惡性腫瘤只佔不到胃腸道惡性腫瘤的2%，且過去臺灣地區的研究皆只限於西部。因此，本院調查自民國84年4月至民國95年3月間，發生於台東地區的此罕見疾病。在所有的15個病例中，以基質瘤最多，腺癌居次；而淋巴瘤第三，類癌第四。此與民國80年以前西部地區的報告有一明顯的不同－淋巴瘤的比例減少；其原因不明，但值得進一步的研究。此外，原住民的腫瘤發生率按人口比例粗估，似乎比非原住民來的高，此有待更長時問及更多病例的追蹤分析，才能確定。由於病理學的進步，使得對於過去的平滑肌肉瘤有一個新的定義及名稱－基質瘤。本篇研究發現，小腸原發性惡性腫瘤男多於女，且平均年齡為61.8歲，常以腹痛為主要的症狀；且越早發現，越早開刀，其預後較佳。是以，我們需要更精確的診斷工具及更新且有效的治療方法，如此才可以改善此病的預後。

關鍵字

平滑肌肉瘤 ； 平滑肌瘤 ； 基質瘤 ； 類癌

並列摘要

Primary malignant tumors of the small intestine represent less than 2% of all gastrointestinal malignancies. In Taiwan, published investigations of these tumors have been limited to hospitals on the west coast. We retrospectively evaluated cases of small bowel malignancies seen at our hospital in Taitung on the east coast of Taiwan from April 1995 to March 2006. The most common diagnoses among the 15 cases we found were stromal tumor, followed by adenocarcinoma, lymphoma and carcinoid tumor. For unknown reasons, lymphoma appeared to be less common in our series than in those before 1991 from western Taiwan. The incidence of these tumors was higher in the aboriginal as compared with the non-aboriginal population of Taitung, although a larger series is probably needed to confirm the discrepancy. The Ieiomyoma and leiomyosarcoma have been more recently classified as gastrointestinal stromal tumors. In our series, more men than women had small bowel malignancies. The average age at diagnosis was 61.8, and the commonest symptom was abdomen pain. Not surprisingly, survival was better among patients with tumors discovered in the early stage. Greater awareness of the possibility of these rare cancers might enhance early diagnosis.

並列關鍵字

Leiomyosarcoma ； Leiomyoma ； Stromal tumor ； Carcinoid tumor