胃肠道间质瘤48例临床分析

Analysis of 48 cases with gastrointestinal stromal tumor

目的:研究胃肠道间质瘤(GIST)的临床特点、治疗方法和预后。方法:回顾性分析1998年1月～2008年12月我院确诊的48例胃肠道间质瘤患者的临床资料。48例均行手术治疗,37例位于胃部肿瘤行近端或远端胃大部切除术,11例位于小肠肿瘤行相应的系膜及肠管部位切除,并检测免疫组化指标CD117、CD34、SMA、S-100。结果:所有患者手术切除率达100%,未发生严重并发症。免疫组织化学检测CD117阳性率为94.4%,CD34阳性率为70.8%。48例患者中40例患者得到随访,随访率为83.3%,8例死亡。结论:CD117和CD34是诊断胃肠道间质瘤最有价值的血清学指标,GIST的确诊依靠病理学检查,螺旋CT有助于手术前诊断;手术切除是治疗的主要方法。

Objective：To explore the clinic feature,treatment and prognosis of gastrointestinal stromal tumor（GIST）.Methods：Clinic data of 48 GIST cases admitted from Jan 1998 to Dec 2008 were analyzed,retrospectively.All cases received surgery,including 37 cases with stomach tumor treated by proximal or distal subtotal gastroectomy;while 11 cases with small intestinal tumor treated by corresponding mesenterium and intestinal canal resection and assay of CD117,CD34,SMA,S-100.Results：The resection rate was 100%,and no serious complication occurred.Immunohistochemical assay showed positive rates of CD117 and CD34 were 94.4% and 70.8%,respectively.The follow-up was carried out to 40 cases（83.3%）,and 8 cases died.Conclusions：CD117 and CD34 are most valuable serological indexes.The dignosis of GIST in dependent on pathological test,and assissted by spiral CT.Resection surgery is the main option.