十二指肠间质瘤五例临床分析

Clinical analysis of 5 cases of duodenal gastrointestinal stromal tumors

目的 探讨十二指肠间质瘤的诊断和治疗.方法 回顾性分析天津市第三中心医院2002年4月至2009年5月收治的5例十二指肠间质瘤临床资料.结果 十二指肠间质瘤发病部位主要集中在降部和水平部;内镜、X线钡餐和CT为最常用的辅助检查手段.5例中行胰十二指肠切除2例,十二指肠节段切除1例,肿瘤局部切除2例.术后2例复发,其中1例给予格列卫辅助治疗.结论 手术切除是治疗十二指肠间质瘤惟一有效的方法.根据十二指肠间质瘤大小和位置应采取不同的手术方式.对于病理分级呈高度危险病人术后应给予格列卫辅助治疗.

Objective To analyze the features of clinical diagnosis and treatment of duodenal gastrointestinal stromal tumors（GIST）.Methods Retrospective analysis was performed on clinical data of 5 cases of duodenal GIST treated in our hospital between April 2002 and May 2009.Results The duodenal GIST was mainly located in the 2nd（3/5）and 3rd portion of duodenum（2/5）.Clinical diagnosis of the disease mainly depended on barium meal examination, gastrointestinal endoscopy, and CT scanning.Two patients were treated with pancreaticoduodenectomy, 1 with segmental duodenectomy and 2 with local resection.After operation, 2 patients had recurrence and 1 of them underwent adjuvant therapy with Gleevec.Conclusion Surgical resection is the only effective therapeutic method for duodenal GIST.Various surgical procedures are mainly determined by the location and size of the tumors.For patients with a high degree of pathologic grade, adjuvant therapy with Gleevec is necessary.