引用文本：王地焘, 张露, 向倩. 以肠梗阻为表现的原发性回肠外生型印戒细胞癌1例[J/CD]. 消化肿瘤杂志（电子版）, 2026, 18(1): 163-169.

作者：王地焘¹，张露²，向倩²

单位：1. 陆军军医大学（第三军医大学）第一附属医院（西南医院），重庆 400038；2. 陆军军医大学（第三军医大学）第一附属医院（西南医院）消化内科，重庆 400038

Authors：Wang Ditao¹, Zhang Lu², Xiang Qian²

Unit：1. The First Affiliated Hospital (Southwest Hospital)，Third Military Medical University (Army Medical University), Chongqing 400038, China；2. Department of Gastroenterology, the First Affiliated Hospital (Southwest Hospital)，Third Military Medical University (Army Medical University), Chongqing 400038, China

摘要：

原发于胃肠道的印戒细胞癌好发于胃，亦可发生于结直肠和胆囊等，而原发于小肠的印戒细胞癌较为罕见，且临床表现缺乏特异性，易被误诊或延迟诊断。2024年1月陆军军医大学（第三军医大学）第一附属医院（西南医院）消化内科收治1例以肠梗阻为首发症状的回肠外生型肿瘤患者，通过全消化道碘水造影确定病变位置，以外科手术切除回肠病灶，最终诊断为回肠印戒细胞癌。患者术后接受8个疗程的贝伐珠单抗联合奥沙利铂+卡培他滨治疗后，病情有所改善，肠系膜淋巴结及腹膜的病灶较前缩小，但停止治疗后病情恶化，出现腹腔多发转移及骨转移。本文总结了相关的诊疗经过，以期为临床实践提供参考。

关键词：回肠印戒细胞癌；小肠梗阻；碘水造影；治疗；预后

Abstract：

Signet ring cell carcinoma (SRCC), which originates in the gastrointestinal tract, is more common in the stomach, but can also occur in the colon, rectum, and gallbladder, etc. However, SRCC originating in the small intestine is relatively rare, and its clinical manifestations are non-specific, making it prone to misdiagnosis or delayed diagnosis. In January 2024, a patient with an exophytic ileal tumor presenting with intestinal obstruction as the initial symptom, was admitted to the Department of Gastroenterology, the First Affiliated Hospital (Southwest Hospital)，Third Military Medical University (Army Medical University). The lesion was localized through gastrointestinal iodine water contrast imaging and subsequently resected by surgery. The final diagnosis was ileal SRCC. The patient's condition improved after 8 courses of bevacizumab combined with oxaliplatin + capecitabine treatment postoperatively, with shrinkage of the lesions in the mesenteric lymph nodes and peritoneum. However, the disease progressed after treatment cessation, with the development of multiple abdominal and bone metastases. This article summarizes the diagnosis and treatment process of this case to provide insights for clinical practice.

Key words：Ileal signet ring cell carcinoma; Small bowel obstruction; Iodine water contrast imaging; Treatment; Prognosis

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