胃肠道间质瘤32例诊治体会

Analysis of the diagnosis and treatment of 32 cases of gastrointestinal stromal tumor

目的探讨胃肠间质瘤(GIST)的诊断和治疗。方法回顾性分析32例GIST的临床资料及预后。结果仅7例源于胃者术前超声内镜考虑GIST,CD117阳性100%(32/32)和CD34阳性75%(24/32)。肠GIST与胃GIST高度风险率分别为61.54%、26.32%,差异有显著性意义(P<0.05)。32例均行手术切除,其中姑息性切除9例,根治性手术23例,无手术死亡。随访1～120个月,中位随访时间25个月,带瘤生存5例,死亡12例(37.5%),3例患者术后伊马替尼辅助治疗,1例带瘤生存。结论 GIST术前诊断较困难,最终确诊靠免疫组织化学染色。只有彻底切除肿瘤才有好的疗效,使用伊马替尼有助提高疗效。

Objective To investigate the diagnosis and treatment of gastrointestinal stromal tumor （GIST）. Methods The clinical data and prognosis of 32 patients with GIST were retrospectively analysed. Rusults Only 7 patients with gastro stromal tumor diagnosed by pre-operatlve endoscopic ultrasonography, The positive rat of CDll 7 was 100%（32/32） and the positive rat of CD34 is 75% （24/32）.The high risk rats of gastral stromal tumor and intestinal stromal tumor were 61.54% and 26.32% respectively, the difference was Significant （P〈0.05）. All these cases underwent surgery, in which,9 cases were palliation excision,23 cases were radical excision and there were no operative deaths. After followed up for 1 month to 120 months （average 25 months）,there were 5 Tumor-bearing living,12 case （37.5%） died, 3 patients received adjuvant treatment with imatinib after the operation, in which, 1 Tumor-bearlng riving. Conclusions The preoperative accurate diagnosis of GIST was difficult, it is final diagnosis relying on immunohistochemistry technique. Only complete excision of tumor would get satisfied results and Additional therapy with imatinib be helpful to increase therapeutic effect.