胃肠道间质瘤的临床诊断及治疗分析

Clinical diagnosis and treatment of gastrointestinal stromal tumor

目的探讨胃肠道间质瘤的临床诊断和治疗方法。方法收集我院从2005年2月1日至2008年7月30日期间61例手术治疗的胃肠道间质瘤患者临床资料，对其临床特点、病理资料、诊断和治疗方法等进行回顾性分析。结果本组患者中位发病年龄为56岁，男女发病无明显差异。患者起病初期无特异性症状和体征，常见症状表现为腹部不适、腹痛、便血。消化内镜、CT等检查可发现肿瘤，免疫标志物CD34、CD117在胃肠道间质瘤中有较高表达，通过病理组织学及免疫组化检查可明确诊断。病理分级可以帮助判断预后。结论胃肠道间质瘤患者术前明确诊断较困难，CT、MRI、EUR、内镜检查等对诊断有重要作用。手术切除肿瘤和应用靶向药物为主要治疗方法。

Objective To study the clinical diagnosis and treatment of gastrointestinal stromal tumor （GIST）. Methods The clinical data, including clinical manifestation, pathology, diagnosis and treatment of 61 patients with GIST,were analyzed. Results The average age of onset was 56,with-out great sex differences. No specificity in manifestation was noted in this disease. Gastrointestinal hemorrhage, abdominal discomfort and/or pain commonly occurred. Tumors could be detected by digestive endoscopy, CT, etc. The immunological markers CD34 and CD117 were highly expressed in GISTs. The diagnosis could be confirmed by histology and immunohistology. The pathological grading was helpful for evaluating the prognosis. Conclusion Making a definite diagnosis of GIST before operation was usually difficult. CT scan, MRI,EUR and endoscope played an important role in the diagnosis of GISTs. Resection of the tumors and targeted therapy were the main treatment for this disease.