胃间质瘤70例临床诊治分析

The Diagnosis and Treatment of Gastric Stromal Tumor:Report of 70 Cases

目的探讨胃间质瘤的诊治方法及预后。方法对70例经手术治疗的胃间质瘤的临床资料进行回顾性分析。结果行远端胃大部切除术16例,近端胃大部切除术22例,胃楔形切除32例。肿瘤平均直径5.4cm,胃周淋巴结转移2例(2.9%)。免疫组化结果CD117阳性66例(94.3%),CD34阳性53例(75.7%),SMA阳性24例(34.3%),Desmin阳性8例,S100阳性8例。术后复发5例,远处转移6例,术后5年生存率为71.3%。良、恶性胃间质瘤组5年生存率分别为92.3%和61.8%(P<0.05)。瘤体直径<5cm与瘤体直径≥5cm组5年生存率分别为95.0%和48.4%(P<0.05)。结论胃间质瘤的治疗以手术为主,其预后主要与肿瘤大小及肿瘤的良、恶性相关。

Objective:To investigate the diagnosis and treatment of gastric stromal tumors(GSTs).Methods:The clinical data of70cases with GSTs were analyzed retrospectively.Results:Wedge resections were performed on32patients and partial gastrectomies on38patients.The median size of tumors is5.4cm in diameter,2of70(2.9%)had lymph node metastasis.66of70(94.3%)were positive for CD117,53(75.7%)positive for CD34,24positive for SMA,8positive for Desmin and S100.10of70patients recurred or metastasized.The5-year survival rate in this series was71.3%.The5-year survival rate of benign and malignant GSTs were92.3%and61.8%(P<0.05).The5-year survival rate for tumors<5cm and ≥ 5cm were95.0%and48.4%(P<0.05).Conclusions:The primarily treatment of gastric stromal tumor is surgical.Tumor size and mitotic count were found to be important indicators of the prognosis.