胃肠间质瘤17例临床诊治分析

Clinical analysis on 17 patients with gastrointestinal stromal tumor

目的:探讨胃肠间质瘤(GIST)的临床表现、诊断与治疗方法。方法:收集治疗的GIST患者17例,采取回顾性方法进行分析。结果:17例患者平均年龄54岁,不同程度上表现为消化道出血、腹部隐痛、腹部包块及贫血。均行手术治疗,肿瘤位于胃13例,小肠3例,直肠1例,术后病理检查确诊,7例为良性,10例为低度恶性和恶性,免疫组化表型以CD117、CD34及Vim-entin阳性率较高。结论:GIST临床症状无特异性,术前确诊率低,确诊主要依靠术后病理学观察及免疫组化检测。纤维内镜、超声内镜、B超、CT等检查的综合应用有助于术前诊断,确诊有赖于病理检查及免疫组化表型分析。

Objective To discuss the clinical manifestations,diagnosis and treatment of gastrointestinal stoma tumors （GIST）.Method A retrospective analysis was made on 17 GIST patients hospitalized in our hospital.Results The average age was 54 years.The patients manifested as gastrointestinal bleeding,abdominal pain,abdominal mass and anemia in different degrees.All patients underwent surgery,13 patients with tumors in the stomach,3 cases in small intestine,1 case in rectum.Postoperative pathological diagnosis proved 7 cases were benign,10 cases of low grade malignant or malignant.Immunohistochemical phenotype results revealed that CD117,CD34 and Vimentin had the higher positive rates.Conclusion The clinical symptoms of GIST is non-specific,with low definite diagnosis rate before operation,and definite diagnosis is mainly depending on post-operative pathological observation and immunohistochemical test.The comprehensive application of fiber endoscope,ultrasonographic endoscope,type-B ultrasound,CT and other tests will conduce to preoperative diagnosis.The definite diagnosis depends on pathological examination and immunohistochemical phenotype analysis.