恶性胃间质瘤的诊断与外科治疗

The Diagnosis and Surgical Treatment of Malignant Gastric Stromal Tumors

目的探讨恶性胃间质瘤的诊断及治疗方法。方法对48例经手术治疗的恶性胃间质瘤的临床资料进行回顾性分析。结果本组中临床症状表现为上腹不适或疼痛29例,上消化道出血18例,腹部包块5例。行胃楔形切除术17例,近端胃大部切除术19例,远端胃大部切除术12例。肿瘤平均直径为7.2cm,胃周淋巴结转移2例(4.2%)。免疫组化结果CD117阳性46例(95.8%),CD34阳性39例(81.3%)。术后复发5例,远处转移6例,5年生存率为61.8%。结论恶性胃间质瘤的诊断主要依靠术后切片及免疫组化,治疗以手术为主,术后复发及转移的发生率较高,其预后主要与肿瘤大小相关。

Objective To investigate the diagnosis and surgical treatment of malignant gastric stromal tumors.Methods The clinical data of 48 cases with malignant gastric stromal tumor were analyzed retrospectively.Results The main symptom was abdominal pain ( 60.4% ), GI bleeding ( 37.5% ) and mass( 10.4% ). Wedge resections were performed on 17 patients and partial gastrectomies on 31 patients. The median size of tumors is 7.2cm in diameter, 2 of 48( 4.2% ) had lymph node metastasis. 10 of 48 patients recurred or metastasized. 46 of 48 ( 95.8% ) were positive for CD117, 39 positive for CD34. The 5 year survival rate in this series was 61.8% .Conclusion The primarily treatment of malignant gastric stromal tumors is surgical. Recurrence and metastasis were usual. Tumor size was found to be important indicator of the prognosis.