胃肠道间质瘤的诊断和外科治疗

Diagnosis and surgical treatment of gastrointestinal stromal tumor

目的探讨胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的临床特点及手术方法,提高诊治水平。方法回顾性分析55例胃肠道间质瘤患者的临床资料,对其临床特点、病理及免疫组织化学检测及手术方法进行总结。结果胃肠道间质瘤可发生于消化道的任何部位,以胃多见(56.3%),其次为小肠(38.2%)、结肠和直肠(3.6%)。免疫组织化学检测:CD117阳性53例,占96.4%;CD34阳性41例,占74.5%。手术方法为行胃大部切除27例(49.1%),小肠部分切除21例(38.2%),胃部分切除4例(7.3%)。结论胃肠道间质瘤治疗以手术为主,术中应根据肿瘤大小、部位、有无外侵及淋巴结转移确定手术范围,切除在于完全而不在于大范围清扫。

Objective Summarize the clinical characteristics and surgical methods of gastrointestinal stroreal tumor to improve the diagnosis and treatment. Methods Retrospectivly analyse the clinical data of 55 cases of gastrointestinal stromal tumor patients, summarize its clinical features, pathology and immunohistochemistry and treatments. Results GIST can occur at any part of the digestive tract, and more common in the stomach （56.3%） , followed by small intestine （38.2%）, colon and rectum （3.6%）. Immunohistochemical investigation CDll7 positive in 53 cases, accounting for 96. 4% ; CD34 positive 41 cases, accounting for 74.5%. Surgical methods were gastrectomy 27 cases （49.1%）, gastric partial resection in 4 cases （7.3%） and small intestine intestines removed in 21 cases （38.2%）. Conclusions GIST treated with surgery-based, surgery should be based on tumor size, location, availability of foreign invasion and lymph node metastasis to decided the surgical scope, excision is up to totally not in a wide range of cleaning.