胃肠恶性间质瘤的临床诊断与治疗

Clinical diagnosis and treatment of 20 cases of malignant gastrointestinal stromal tumors

目的探讨胃肠恶性间质瘤的临床诊断与治疗。方法回顾性分析1998年8月至2007年5月我科手术治疗的24例胃肠恶性间质瘤患者的临床资料。结果胃肠恶性间质瘤成人多见,50岁以上占75%(18/24),临床以消化道出血、贫血、疼痛多见。病变部位胃15例,小肠7例,结肠2例,行根治性切除18例,局部切除5例,姑息性切除1例,其中3例为联合脏器切除。结论内镜和影像学检查是发现胃肠恶性间质瘤的主要手段,术前明确诊断仍较困难。手术切除是病理确诊和治疗的主要方法,必要时需联合脏器切除,以保证肿瘤切除的彻底性,对防止术后复发有重要意义。

Objective To explore diagnosis and treatment of malignant gastrointestinal stromal tumors. Methods Clinical data of 24 cases of malignant gastrointestinal stromal tumors undergone surgical operation were retrospectively reviewed and analyzed. Results Most of these pa- tients with malignant gastrointestinal stromal tumor were adults. Patients /〉50 years old were accounted for 75% （18/24）. Gastrointestinal hemor- rhage, anemia and pain were frequendy occurred as their main clinical manifestations. Tumors in 15 cases were located in fundus of stomach, 7 in small intestine and 2 in colon. Endoscopy and/or imaging examinations were performed before operation. Eighteen cases were undergone radical subtotal or total resection, 5 with local resection, 1 with palliative total resection and 3 of them with combined resection of related viscera. Conclu- sion Endoscopy and imaging examination are main methods for detection of malignant gastrointestinal stromal tumor. Preoperational diagnosis is still difficult. Surgical resection is the main method for pathologic diagnosis and treatment. Sometimes combined resection of related viscera is nec- essary for ensuring complete resection of the tumor and it is also important in prevention of recurrence of the tumor.