胃肠间质瘤24例临床分析

Clinical analysis of 24 cases with gastrointestinal stromal tumor

目的探讨胃肠问质瘤（GIST）的诊断及治疗。方法回顾性分析解放军第八十八医院普外科2007年1月。2011年1月，经手术病理证实的24例GIST临床资料。结果肿瘤发生于胃部11例，十二指肠1例，小肠8例，结肠2例，直肠2例。行腹腔镜下胃肿瘤切除和小肠肿瘤切除术5例；2例直肠GIST经肛门切除；17例行开腹手术，无广泛转移病例，无手术死亡病例。术后仅有4例患者按疗程口服伊马替尼辅助治疗，其余患者均未服药，22例获随访，中位随访时间26个月，均未见肿瘤复发转移。结论外科手术是GIST治疗的首选，对恶性或潜在恶性的胃肠间质瘤患者需行伊马替尼辅助治疗，但因伊马替尼价格昂贵，对于无远处转移及局部广泛浸润转移患者，外科根治性手术切除意义重大。

Objective To study the diagnosis and treatment of gastrointestinal stromal tumors （ GIST ）. Methods A clinical data of 24 patients with GIST proved pathologically were retrospectively analyzed, admitted to our hospital from January 2007 to January 2011. Results The tumors originated respectively from the stomach（n=l 1）,duodenum （n =l）,intestine（n=8）,colon（n=2）, rectum（n=2）. Laparoscopic gastric tumor and small intestine tumor resection in 5 cases; transanal resection in 2 cases with rectal GIST. 17 cases underwent open operation, no widespread metastasis cases, no operation death case. Only 4 patients were given oral imatinib adjuvant treatment after operation, according to the course, the rests had no medication. 22 cases were followed up with 26 months of the median follow-up time, no tumor recurrence and metastasis. Conclusion Curative resection is the first choice for treatment of GIST. The patients with malignant GIST or potential malignant GIST must be performed adjuvant therapy with imatinib. But imatinib is expensive, surgical radical surgery has great significance for no distant metastasis and local metastasis patients.