十二指肠间质瘤16例临床分析

GASTROINTESTINAL STROMAL TUMORS OF DUODENUM:A CLINICAL ANALYSIS OF 16 CASE

目的探讨十二指肠间质瘤的诊断和治疗。方法回顾性分析了16例十二指肠间质瘤治疗的临床资料。结果十二指肠间质瘤发病部位主要集中在降部和水平部;出血是最常见的临床症状,其次为上腹部疼痛不适,内镜和CT为最常用的辅助检查手段,16例中行胰十二指肠切除2例,十二指肠节段切除9例,肿瘤局部切除5例,术后随访6-42个月,1例复发并出现肝脏转移存活22个月,其余均未发现复发。结论根据十二指肠间质瘤大小和确切位置应采取不同的手术方式,大部分患者可通过十二指肠节段切除或局部切除达到根治目的,对于病理分级呈高度危险患者术后应给予伊马替尼辅助治疗。

Objective To analyze the features of clinical diagnosis and treatment of duodenal gastrointestinal stromal tumors （GIST）. Methods Clinical and pathological data of 16 cases of duodenal gastrointestinal stromal tumors admitted between August 2001 and April 2006 were analyzed retrospectively. Results The duodenal gastrointestinal stromal tumors were mainly located in the 2nd （8/16）and 3rd portion of duodenum （5/16）. The most common presentation of duodenal gastrointestinal stromal tumors was bleeding（7/16）, Clinical diagnosis of the disease mainly depends on gastroinstinal endoscopy and CT. 2 patients were treated with pancreat-icoduodenectomy and 14 patients underwent partial resection of duodenum. Following resection, 1 patient had reccurred and died 22 months after operation. 15 cases are without disease. Conclusion Various surgical procedures for duodenal gastrointestinal stromal tumors should be adopted depending on the size and exact site of the lesion. Most of the patients with duodenal gastrointestinal stromal tumors can be resected completely by partial resection of the duodenum, For the patients with high risk degree of pathologic grade, adjuvant therapy with Imatinib is necessary.