247例小肠平滑肌肿瘤的病理临床研究

Pathological and clinical study of 247 cases of smooth muscle tumors arising in the small intestine

报告247例小肠平滑肌肿瘤,内Ⅰ级(平滑肌瘤)80例.Ⅱ级(低度恶性平滑肌肉瘤)65例.Ⅲ级(平滑肌肉瘤,包括上皮样平滑肌肉瘤)102例.随访Ⅲ例.内Ⅰ级23例全部存活;Ⅱ～Ⅲ级存活49例.其中21例已发生转移;死亡39例.5年生存率为23.1%,10年生存率为7.7%。预后与分级和瘤体大小有关,>5或<5 cm 可作为判断预后的参考指标.其病理恶性指标应综合判断之。该瘤生长慢、转移晚,对其原发瘤及转移瘤的手术治疗应持积极态度,可望治愈或延长生命.随访时间要适当延长.

247 cases of smooth muscle tumor(SMT)were analy- sed,including 80 cases of grade Ⅰ(leiomyma),65 cases of grade Ⅱ(low malignant leiomyosarcoma)and 102 cases of grade Ⅲ(leiomyosarcoma, including epithelioid leiomyosarcoma).The follow-up data of 111 cases of SMT showed that 23 cases of grade Ⅰ SMT patients survived.Of grade Ⅱ-ⅢSMT,49 are still alive(including 21 metastasis)and 39 died. The survival rate was 23.1% for 5 years and 7.7% for 10 years.Fac- tors having an effect on the prognosis included grades and sizes(≥5cm) of SMT.It was suggested that density of tumor cell,cell anaplasia, mitotic figures and their behavior may be considered as the criteria for the diagnosis of malignant SMT.This tumor developed slowly and its metastasis occured late.So that,surgical treatment of the original and metastasis tumor may be effective.