36例胃肠道间质瘤的临床诊治

Clinical diagnosis and treatment of gastrointestinal stromal tumors

目的 总结胃肠道间质瘤（GIST）的临床诊疗经验和病理学特征.方法 回顾性分析1995年1月至2005年4月收治的36例GIST的临床和病理资料.结果 最常见临床表现为腹部隐痛不适19例,消化道出血12例,腹部包块7例.最常见病变部位为胃26例,小肠8例.病程1天～2年.肿块平均直径7.2 cm.CD117阳性29例,CD34阳性30例.总的随访率为31/36（86.1%）,11例死亡.结论 GIST术前确诊较困难,确诊主要依靠病理学观察和免疫组化检测,联合CD117和CD34检测可提高GIST诊断.手术完整切除肿瘤是治疗GIST的关键.

Objective To review the clinical diagnosis, treatment and pathology of gastrointestinal stromal tumor （GIST）. Methods Clinical and pathological data of 36 patients with GIST who were admitted between Jan. 1995 and April 2005 were analyzed retrospectively： Results The common clinical manifestations were abdominal pain, digestive tract bleeding and abdominal mass. The most common tumor loeations were the stomach and small intestine. The mean tumor size was 7.0era. Of the 36 cases, 29 were positive for CD117, and 30 for CD34. Thirty-one patients were sueeessfully followed up, and 11 patients died. Conclusions Preoperalive diagnosis of GIST is difficult and mainly depends on pathological and immtmohistoehemical study. Combination of CD117 and CD34 can increase the diaguosis of GIST. Surgical radical resection is the treatment of choice for GIST.