胃恶性间质瘤20例诊断与治疗

Diagnosis and treatment of 20 cases of malignant gastric stromal tumor

目的：探讨胃恶性间质瘤的临床诊断与治疗。方法：回顾性分析1997年9月～2005年4月我科手术治疗的20例胃恶性间质瘤患者的临床资料。术前行胃镜及（或）影像学检查，14例行根治性胃大部切除或全胃切除，5例局部切除，1例姑息性全胃切除，其中5例为联合脏器切除。结果：胃恶性间质瘤成人多见，50岁以上占70％（14／20），临床以消化道出血、贫血、疼痛多见。全组无围手术期死亡，术后无主要并发症，均痊愈出院。结论：内镜和影像学检查是发现胃恶性间质瘤的主要手段，术前明确诊断仍较困难。手术切除是病理确诊和治疗的主要方法，必要时需联合脏器切除，以保证肿瘤切除的彻底性，对防止术后复发有重要意义。

Objective：To explore the diagnosis and treatment of malignant gastric stromal tumors. Methods：The clinical data of 20 cases of malignant gastric stromal tumor having received surgical management were reviewed. Fourteen cases underwent radical subtotal or total gastrectomy,5 local resections, 1 parative total gastrectomy and 5 combined resection of other viscera. Results： Most of the patients with malignant gastric stromal tumors were adults. The patients ≥50 years of age accounted for 70% （14/20）. Gastrointestinal hemorrhage,anemia and pain were the main clinical manifestations. There were no perioperative death and main postoperative complication,all cases healed. Conclusions： Endoscopy and imaging examination are the main methods to detect malignant gastric stromal tumors. Preoperation diagnosis is still difficult. Surgical resection is the main method for pathologic diagnosis and treatment. Sometimes combined resection of other viscera is necessary to ensure the tumor completely resected, which is of great value to prevent recurrence of the tumor.