胃肠道间质瘤120例临床分析

Analysis of 120 cases of gastrointestinal stromal tumors

目的:分析胃肠道间质瘤的临床特征与诊断。方法:回顾性分析经手术和病理确诊的120例胃肠道间质瘤病例资料。结果:肿瘤发生于胃60.0%(72/120),空回肠27.5%(33/120),十二指肠8.3%(10/120),结直肠4.2%(5/120)。72例胃间质瘤中22例为恶性(30.5%),33例空回肠间质瘤中27例为恶性(81.8%)。空回肠间质瘤恶性率高于胃间质瘤(P<0.05)。肿瘤发生坏死20例,其中18例为恶性(90.0%),Ki-67>15%者15例均为恶性。出现坏死或Ki-67>15%的胃肠道间质瘤恶性率高(P<0.05)。11例复发或转移者用甲磺酸伊马替尼治疗,6例有效。结论:胃肠道间质瘤的临床特征可初步判断肿瘤恶性程度,复发或转移者可以试用甲磺酸伊马替尼治疗。

Objective：To analyze the clinical character and diagnose of gastrointestinal stromal tumors.Methods：A retrospectively analysis was conducted in 120 cases of gastrointestinal stromal tumors confirmed by surgery and pathology.Results：The most frequent localizations were the stomach（60.0%）and the jejunum and the ileum（27.5%）.It was rarely localized in the colorectum（4.2%）and the duodenum（8.3%）.Twenty-two in 72 gastric stromal tumors were malignant and 27 in 33 jejunoileal stromal tumors were malignant.The ratio of malignant lesions in jejunoileal stromal tumors were significantly higher than in gastric stromal tumors（P〈0.05）.Eighteen in 20 gastrointestinal stromal tumors with a area of necrosis were malignant.Fifteen gastrointestinal stromal tumors with increased expression of Ki-67（〉15%）were all malignant.Gastrointestinal stromal tumors with a area of necrosis or with increased expression of Ki-67（〉15%）had been linked to a less favorable prognosis.Six in 11 postoperative recurrence or metastase of gastrointestinal stromal tumors in the use of Imatinib were effective（54.5%）.Conclusions：The clinical character of gastrointestinal stromal tumors can be used to preliminarily predict malignant degree.Postoperative recurrence or metastase of gastrointestinal stromal tumors in the use of imatinib are effective.