胃间质瘤的诊治分析

Diagnosis and treatment gastric stromal tumor

目的探讨胃间质瘤(Gastric Stromal Tumor,GST)的诊断和治疗。方法回顾分析病理诊断明确的30例胃间质瘤患者,对其生物学行为进行恶性潜能分级。结果胃间质瘤发病年龄37-75岁,平均55岁,性别差异不明显。肿瘤多单发,好发于胃底及胃体,胃窦少见。生物学行为恶性潜能分级低、中、高风险性分别为26.7%、23.3%、50%。临床表现无特异性,最常表现为上消化道出血、中上腹疼痛及腹部肿块。内镜检查有助于早期诊断,表现为胃内肿块、半球形或扁平隆起,表面可光滑或有溃疡样凹陷。确诊需依靠病理切片、免疫组化检查,CD117诊断特异性最高。手术治疗仍是目前最有效的治疗方法。结论胃间质瘤是一种独立的、非定向分化的间叶性肿瘤,内镜检查和病理免疫组化如CD117标记可协助早期诊断,确诊后应及早行手术治疗,终身随访。

Objective To study the diagnosis and treatment of gastric stromal tumor.Methods Diagnosis and treatment of 30 patients with gastric stromal tumor were retrospectively analyzed and biological behavior of the tumor was staged according to its potential malignancy.Results Gastric stromal tumor occurred in patients at the age of 37-75 years（mean age：55 years） with no difference in sex.The tumor was found at multiple sites,especially at the fundus and body of stomach,but rarely at antrum.The low,moderate and high malignancy of its biological behavior was 26.7%,23.3% and 50%,respectively.The patients had no specific clinical manifestations,but usually had bleeding in the upper digestive tract,pain in the middle and upper abdomen,and abdominal mass.Endoscopy could show the tumor mass in stomach,thus contributing to its early diagnosis confirmed by pathology and immunohistochemistry.Surgical operation remained the best procedure for it.Conclusion Gastric stromal tumor is an independent and non-directionally differentiated tumor.Gastroscopy and immunohistochemistry contribute to its early diagnosis.Operation should be performed immediately after its diagnosis is established.The patients should be followed up till to their end of life.