94例胃肠道间质瘤临床诊治分析

Diagnosis and treatment of gastrointestinal stromal tumor:An analysis of 94 cases

目的:探讨胃肠道间质瘤(GIST)的诊断与治疗。方法:对1998年1月-2007年12月收治的94例GIST患者病理特点及外科治疗进行回顾性分析。结果:本组GIST发生部位:胃54例(57.4%),小肠22例(23.4%),结肠11例(11.7%),直肠6例(6.4%),肛管1例(1.1%)。主要临床表现为消化道出血(56.3%)和腹部肿块(32.1%),94例均行手术切除。术后1年、3年、5年存活率为83.4%、53.2%、38.8%,良性及交界性患者均无复发;23例恶性患者中9例复发,其中5例死亡。结论:GIST以胃及小肠最多见,以消化道出血、腹部肿块表现为主。GIST的诊断有赖于病理形态学检查与免疫组化的结合。完整的手术切除是最有效的治疗手段。

Objective： To study the diagnosis and treatment of gastrointestinal stromal tumor（GIST）. Methods： Clinical symptoms, pathologic characteristics, and surgical treatment of 94 GIST patients admitted from January 1998 to December 2007 were retrospectively analyzed. Results： GIST was located in stomach of 54 cases （57.4%） , in small intestine of 22 cases （23.4%） , in colon of 11 cases （ 11.7% ）, in rectum of 6 cases （6.4%）, and in anal canal of 1 cases （ 1.1% ）, respectively. The main clinical manifestations of GIST were alimentary tract hemorrhage （56.3%） and abdominal mass （32.1%）. The 1, 3 and 5 year survival rate of 94 patients was 83.4% , 53.2% , and 38.8% , respectively. No recurrence was found in patients with benign GIST. Recurrence was found in 9 out of 23 patients with malignant GIST, 5 of them died. Conclusion： GIST frequently occurs in stomach and small intestine of aged people. Its main clinical manifestations are alimentary tract hemorrhage and abdominal mass. The diagnosis of GIST depends on its pathology and immunohistochemistry. Complete resection of GIST is the best choice of treatment.