胃肠间质瘤28例诊治分析

Study on diagnosis and treatment of gastrointestinal stromal tumors in 28 cases

目的探讨胃肠间质瘤(GIST)的诊治方法。方法回顾性分析我院1999年1月至2007年1月收治的胃肠间质瘤28例临床资料。结果肿瘤部位以胃肠为主,本组均行手术治疗。术后病理诊断8例良性,20例为潜在恶性和恶性;免疫组化CD34阳性19例(67.9%),CD117阳性28例(100%),抗平滑肌抗体(SMA)和S-100均(-)。复发12例,再切除6例。结论对于腹部隐痛不适、反复消化道出血的中老年病人,如胃结肠内镜无阳性发现应高度怀疑本病。CT检查对术前确诊帮助较大,GIST的诊断依靠免疫组化分析。完整的局部切除是最有效的治疗手段。

Objective To study the diagnosis and treatment of gastrointestinal stromal tumors（GIST）.Methods The clinical data of 24 patients with GIST admitted into surgical department from Jan 1999 to Jan 2007 were retrospectively analyzed.Results The resection of gastrointestinal stromal tumors was undertaken in 28 cases.Stomach and small bowel are often affected by this tumor.The tumors were benign in 8 cases and malignant in 20 cases.The expression of CD34 and CD117 had been seen in 19 cases（67.9%）and 28 cases（100%）respectively with immunohistochemical staining.But immunohistochemical staining for SMA and S-100 was negative in all cases.Recurrence occurred in 12 cases,and 6 of them underwent tumor resection again.Conclusion Gastrointestinal stromal tumors should be highly suspected in aged persons with abdominal pain,gastrointestinal bleeding and negative result in gastroscopy and enteroscopy.CT scanning is helpful for preoperative diagnosis.The diagnosis of gastrointestinal stromal tumors mainly depends on immunohistochemical staining.Complete resection of the tumor is the most effective therapeutic measure.