32例小肠间质瘤的诊治体会

Diagnosis and treatment for small intestinal stromal tumor of 32 Cases

目的:分析总结小肠间质瘤,提高诊断及处理水平。方法:回顾性分析我院近10年经手术及病理证实的32例小肠间质瘤的临床病理特点。结果:小肠间质瘤良、恶性之比1∶5.4。恶性间质瘤的直径大于良性间质瘤。隐性失血、隐匿消瘦、脐周隐痛、腹部肿物是小肠间质瘤的最常见表现。术前确诊为小肠肿瘤59.4%。27例恶性间质瘤中66.7%(18/27)行小肠肿瘤根治术,25.9%(7/27)行小肠肿瘤切除的减瘤荷手术,7.4%(2/27)行姑息手术。27例恶性间质瘤切除标本中6例发生淋巴转移,4例出现远处转移。结论:小肠间质瘤是较少见消化道肿瘤,多种检查方法合理应用可提高术前确诊率、术中对判断性质困难者应行根治性切除术。

Objective： To analyze and summarize the clinical and pathological features for small intestinal stromal tumor. Methods： 32 cases with small intestinal stromal tumors were studied retrospectively. All patients were identified by postoperative histopathological examination. Results： The ratio of benign and malignant stromal tumors was 1：5.4 in present study. Malignant stromal tumors had larger diameters than benign tumors. The main clinical features of these patients consisted of occult bleeding in digestive tract, gradual losing of body weight, mild abdominal pain and abdominal mass. In all cases, 59.4% patients had the definite diagnosis of small bowel tumor preoperatively. The 27 malignant cases were respectively undergone curative operation （66.7%, 18/27）, resection main tumor （25.9% ,7/27） or palliative operation （7.4%, 2/27） including gut bypass, biopsy and laparotomy. There were 6 cases with regional node metastases and 4 cases with distal metastasis in 27 resectable patients by pathologic examination. Condusion： Small intestinal stromal tumors are rare tumors of alimentary tract. The preoperative diagnosis accuracy can be improved by appropriate application of instrument. The radical operation might be the sensible decision if there is difficulty in affirming benign or malignant tumors.