十二指肠间质瘤15例临床分析

Duodenal Stromal Tumor:A Clinical Analysis of 15 Cases

目的探讨十二指肠间质瘤的临床特征、诊断和治疗。方法回顾性分析15例确诊为十二指肠间质瘤患者的临床资料。结果患者以上消化道出血、腹痛、腹胀及腹部包块为常见症状,发病部位以降部和水平部多见,分别经内镜、超声内镜、上消化道钡餐及上腹部CT或MRI、B超检查诊断本病。免疫组织化学检测示:CD117阳性14例,CD34阳性10例。所有患者均行胰十二指肠手术或者联合甲磺酸伊马替尼治疗,预后良好。结论十二指肠间质瘤临床表现无特异性,尽早合理地选择内镜及影像学检查可以提高检出率,组织病理学及免疫组织化学检查可对其进行确诊,早期手术及联合甲磺酸伊马替尼是目前主要的治疗方法。

Objective To investigate the clinical characteristics,diagnosis and treatment of duodenal stromal tumor.Methods Data of 15 cases of confirmed duodenal stromal tumor were retrospectively analyzed.Results The most common symptoms in patients with duodenal stromal tumor were upper gastrointestinal bleeding,abdominal pain,abdominal distension and abdominal mass.The duodenal stromal tumor was mainly located in the descending descending part and horizontal part,and was diagnosed by endoscopy,ultrasonic endoscope,upper gastrointestinal barium meal,CT or MRI,and type B ultrasonography.Immunohistochemical testing showed CD117 positive in 14 cases and CD34 positive in 10.All patients were treated with pancreaticoduodenal surgery alone or in combination with imatinib mesylate and had good prognosis.Conclusion Clinical manifestations of duodenal stromal tumor are non-specific,and reasonable endoscopic and imaging examination can improve the detection rate.Histopathological and immunohistochemical tests are important means for final diagnosis,and early surgery combined with imatinib mesylate is the main treatment at present.