小肠间质瘤的临床分析

Clinical Analysis of Small Intestine Stromal tumors

目的:探讨小肠间质瘤(small intestine stromal tumors,SISTs)的临床表现、影像学特点和治疗措施。方法:收集2002年8月至2007年8月本院普外科治疗的14例SISTs的患者的临床资料进行回顾性分析。结果:14例患者中男6例,女8例,平均年龄(56.8±11.4)岁。SISTs常见的临床表现为:腹痛、腹部包块、肠梗阻、胃肠道出血及体重下降;血清肿瘤学指标均正常。术前9例行消化道气钡双对比造影检查,4例检出病变,均未提示间质瘤可能。14例行CT检查,全部检出肿瘤,定性诊断准确8例;14例患者均行手术治疗,无围手术期死亡。术后病理结果为SISTs,其中良性间质瘤2例,潜在恶性3例,恶性9例。结论:SISTs无特异性临床症状,消化道气钡双对比造影诊断率低,CT扫描具有一定的特征,两种检查互相配合,结合临床具有较高的定位定性诊断价值。早期诊断对改善SISTs的预后十分重要。

Objective： To analyze the clinical manifestation, imaging characteristics and treatment of small intestine stromal tumors （SISTs）. Methods： The clinical data of 14 SISTs patients treated between August 2002 to August 2007 in our hospital were analyzed retrospectively. Results： The patients comprised 6 males and 8 females, with a meanaverage age of （56. 8±11. 4） years. Common clinical manifestation of SISTs included abdominal pain, abdominal lump, intestinal obstruction, gastrointestinal bleeding and weight loss. The levels of serum tumor markers were normal in all patients. Nine patients underwent air-barium double contrast gastrointestinal tract examination before operation. Positive results were found in 4 cases, but none was considered to be SISTs. CT scanning suggested tumor in all of the 14 patients, with confirmed diagnosis in 8. All patients received surgical operation and no death was found during perioperative period. Pathology diagnosis was SISTs in all patients, including 2 cases of benign stromal tumor, 3 of potential malignant and 9 of malignant tumors. Conclusion：There is no special clinical manifestation for SISTs. Air-barium double contrast gastrointestinal tract examination is not very sensitive for SISTs but CT plays an effective role in the diagnosis. Combined use of these two methods with reference to clinical manifestation may yield more definite diagnostic findings. Early diagnosis can be very important for a better prognosis of SISTs. Aggressive surgical removal of SISTs plus adjuvant therapy with imatinib mesylate may resuh in favorable outcomes.