胃肠道间质瘤临床病理特点及诊治分析

Analysis of pathological characteristics,diagnosis and treatment of gastrointestinal stromal tumors

目的探讨胃肠道间质瘤(GIST)临床病理特点及诊治情况。方法对31例GIST患者的临床资料进行回顾性分析。结果全部患者均行手术治疗。31例GIST患者发生部位以胃(19例61.3%)和空肠(6例19.3%)为主。首发症状以腹痛、腹胀(20例64.5%)和消化道出血(12例38.7%)、腹部包块(8例25.8%)为主要表现。病理报告良性13例、潜在恶性2例、恶性16例。免疫组化CD117阳性28例(90.3%),CD34阳性26例(83.9%)。结论(1)GIST消化道症状无特异性,术前确诊率低,易造成误诊;(2)CD117和CD34阳性可以作为GIST的诊断标志;(3)治疗应以局部切除为主,恶性者应扩大切除范围。

Objective To investigate the clinicopathological characteristics and dlagnosis-treatment conditions of gastrointestinal stromal tumors（GIST）. Methods Clinical data of 31 patients with GIST were analyzed retrospectively. Results All 31 patients underwent surgery for their tumors. The tumors were mainly situated in stomach （19 cases,61.3% ）and in jejunum （6 cases, 19.3% ）. Among the 31 cases, people firstly complained with abdominalgia and abdominal distention（20 cases, 64.5% ）, gastrointestinal bleeding（12 cases,38.7% ） ,and abdominal mass （8 cases, 25.8% ）. Postoperative pathology revealed that there were 13 benign cases,2 occult malignant cases and 16 malignant cases. The positive rates by immunohistochemical methods for CDll7 and CD34 were 90.3% （28/31） and 83.9% （26/31）respectively. Conclusions （1）There are a low preoperative diagnostic rate and a high misdiagnosis in GIST for their nonspecific digestive symptoms, （2）CD117 and CD34 can be used as biological markers in the diagnosis of GIST, （3） Toporesection seem to be the principal treatment method for GIST . But in malignant ones, we should enlarge the resection.