胃肠道恶性间质瘤的临床诊治

Diagnosis and treatment of malignant gastrointestinal stromal tumors

目的：探讨胃肠道恶性间质瘤的临床特点。方法：分析1998—2005年我院35例确诊为胃肠道恶性间质瘤患者的临床资料。结果：本病好发于胃（91．4％），男女比例1．9：1，年龄13～82岁。本组患者临床表现无特异性。腹部超声、CT、消化道造影、消化内镜检查为术前常见检查途径，其中超声内镜确诊率最高（75％），腹部超声检查对该病诊断意义不大。35例患者均行手术，甲磺酸伊马替尼被用作术后辅助治疗药物，手术标本免疫组化示CD34（90％）、CD117（80％）的阳性率明显高于其它抗原（P〈0．05）。术后复发率为44％，术后5年生存率为32％。结论：该病预后较差，临床工作中应提高对本病的认识，早期发现，早期治疗，术后定期复查。

Objective： To investigate the clinical feature of the malignant gastrointestinal stromal tumors. Methods： The clinical data of 35 patients with malignant gastrointestinal stromal tumors of our hospital from 1998 to 2005 was reviewed. Results： 91.4% of the malignant gastrointestinal stromal tumors were originated from the stomach. Male female ratio was 1.9 to 1. Age range was from 13 to 82. The clinical manifestations of this group had no specificities. Abdominal sonography, computed tomography （ CT）, GI X-ray series and endoscopy were used to detect the lesions before operation, the final diagnosis rate of the ultrasonic endoscope（75% ） was higher than that of any other method. Abdominal sonography could not make a definite diagno- sis. Surgical resections were performed in all the patients. Irnatinib mesylate was the adjunctive therapy drug after operation. Im- munohistochemical results showed that the positive rate of CD34 antigen （90%） and CDll7 antigen （80%） were more than those of oher antigens （P 〈 0.05 ）. Post-operation recurrence rate was 44%, and post-operation five-year-survival rate was 32%. Conclusion： The prognosis of this disease is poor, so it is important to understand the disease, to discover and treat timely and to recheck regularly after operation.