消化道平滑肌肉瘤的诊断及治疗(附86例报告)

Diagnosis and treatment of 86 cases liomyosarcoma in digestive tract

目的 探讨消化道平滑肌肉瘤的临床病理学特征 ,以提高其诊断及治疗水平。方法 回顾分析本院 1975～ 1996年间收治的消化道平滑肌肉瘤 86例。结果 本病缺乏特异临床症状 ,诊断比较困难 ,主要依靠病理检查中的核分裂相 ;以局限性生长者多见 ,手术切除率为 86% ;术后局部复发者较多 ,占 2 2 5 % ;生存率较低 ,胃、小肠及大肠平滑肌肉瘤的 5年生存率分别为 3 0 %、4 6 1%及 4 1 7%。结论 本病虽多能切除 ,但其复发率高 ,生存率低 ,欲提高其疗效 ,有赖于早期诊断 。

Objective To explore the clinicopathological characters of liomyosarcoma in digestive tract for improving diagnosis and therapeutic efficacy.Methods From 1975 to 1996,86 cases of liomyosarcoma were analysed retrospectively in our hospital.Results Because of non specific clinical findings,the diagnosis was rather difficult and mainly depended on segmentation nuclei of histological examination;The lesion was usually localized and its resected rate was 86%;The local recurrent rate of postoperation was 22.5%;The 5 year survival rate of stomach,intestine and large bowel of liomyosarcoma was 30%,46.1% and 41.7%,respectively.Conclusion The disease had higher resected rate,but higher recurrent and lower survival rate.So the improving efficacy depended on early diagnosis,application of no touch technique and radical operation when the lesion was in small size.