Clues to early diagnosis from clinical data- A clinicopathological analysis of primary malignant tumors of the small bowel

Abstract

Abstract Background Primary malignant tumors of the small bowel (PMTSB) are relatively uncommon in gastrointestinal tumors. It is difficult to make an early diagnosis due to the atypical primary symptoms, special anatomical position and lack of effective diagnostic methods. Objective To improve the level of early diagnosis of PMTSB so as to speculate the pathological types and get better prognoses for patients. Method Clinicopathologic and follow-up data about 104 surgically treated patients with PMTSB (65 males and 39 females) at the median age of 58.1 years (range 23–85 years) were analyzed. Result The most common clinical features of the patients were anemia (73.1%), abdominal pain (62.5%), and weight loss (51.9%). Abdominal enhanced Computed Tomography (CT) had the highest detection rate (95.4%) and diagnosis rate (80%). Gastrointestinal hemorrhage, soft tissue mass on CT, no regional lymph nodes enlargement, and no intestinal obstruction were the independent predictors of diagnosis in GIST. Anemia, intestinal obstruction, without soft tissue mass on CT were the independent predictors of diagnosis in adenocarcinoma. Independent predictors of diagnosis of lymphoma included fever, and regional lymph nodes enlargement on CT. Conclusion Anemia, abdominal pain and weight loss were the main clinical manifestations for PMTSB, as CT was the most effective imaging examination. Based on clinical and imaging features, we analyzed several factors which related to diagnose the pathological classification, and expected to give patients the earlier diagnosis and better prognoses.