胃肠间质瘤87例临床分析

Diagnosis and treatment of gastrointestinal stromal tumors (GIST) :an analysis of 87 cases

目的探讨胃肠间质瘤(GIST)的诊断及治疗。方法回顾性分析复旦大学附属华东医院2000年1月至2008年12月经手术病理证实的87例GIST临床资料。结果肿瘤发生于食管1例,胃部45例,十二指肠3例,小肠23例,结肠3例,直肠3例,盆腔和后腹膜9例。行腹腔镜下胃肿瘤切除术7例;1例直肠GIST经肛门切除;79例行开腹手术,其中8例因肿瘤广泛转移行局部切除或活检,71例完整切除。无手术死亡病例。55例获随访,13例术后复发,其中10例出现肝脏转移。结论外科手术是GIST治疗的首选,对恶性或潜在恶性的胃肠间质瘤病人需行伊马替尼辅助治疗。

Objective To study the diagnosis and treatment of gastrointestinal stromal tumors （GIST）. Methods The clinical data of 87 cases of GIST proved pathologically admitted from January 2000 to December 2008 at Huadong Hospital, Shanghai Fudan University School of Medicine were analyzed retrospectively. Results The tumors originated respectively from the esophago （n= 1）, stomach（n=45）, duodenum （n=3）, intestine（n=23）, colon （n=3）, rectum （n=3） and pelvic cavity（n=9）. Seven eases of gastric GIST were performed by laparoseopic lumpectomy. One ease of rectal GIST was resected transanally. Seventy-nine cases of GIST were performed by laparotomy. Eight of them underwent palliative resection or biopsy because of extensive metastasis. Senventy-one eases were resected completely. There was no operative mortality. Fifty-five cases were followed-up. Thirteen cases had recurrenced anti metastisis,and 10 of them were liver metastisis. Conclusion Curative resection is the first choice tot treatment of GIST. The cases of malignant GIST or potential malignant GIST must be performed adjuvant therapy with imatinibmesylate.