胃肠道间质瘤的临床诊断与治疗

CLINICAL DIAGNOSIS AND TREATMENT OF GASTROINTESTINAL STROMAL SARCOMAS

目的探讨胃肠道间质瘤(GIST)的临床诊断和治疗方法。方法收集我院31例手术治疗的GIST病人的临床资料,对其病理、临床诊断和治疗方法进行分析。结果本组病人平均发病年龄为52.3岁。男女发病无明显差异。本病临床表现无特异性,但临床常以消化道出血、疼痛多见。消化内镜、B超、CT等检查可发现肿瘤,免疫标记物CD34、CD117在GIST中有较高表达,通过病理组织学及免疫组化检查可明确诊断。本组病人均行手术治疗。结论GIST病人术前消化道症状无特异性,明确诊断较困难,CT检查因其具有分辨力高、组织对比好的优势,对间质瘤的定位诊断有重要作用。手术切除肿瘤为主要治疗方法,术后放、化疗的效果难以肯定,靶向治疗前景乐观。

Objective To study the clinical diagnosis and treatment of gastrointestinal stromal tumor （GIST）. Methods The clinical data which included pathology, diagnosis and treatment of 33 patients with GIST were analyzed. Results The average age of onset was 52.3 without great sex differences. No specificity in manifestations was noted in this disease, but gastrointestinal hemorrhage and/or pain were commonly seen. Tumors could be detected by digestive endoscopy, CT, or uhrasonography. The immunological markers CD34 and CD117 were highly expressed in GISTs. The diagnosis could be confirmed by histology and immunohistollogy. All the patients in this study were treated surgically. Conclusion Making a definite diagnosis of GIST before operation is usually difficult as lack of specific digestive symptoms. CT scan plays an important role in tumor localization as it has a high resolution power and better tissue contrast. Resection of the tumors is the main treatment for this disease. The effects of post-operative radiotherapy and chemotherapy are uncertain. The outlook of targeted therapy will be optimistic.