胃肠道间质瘤32例临床分析

Clinical Analysis on 32 Cases of Gastrointestinal Stromal Tumor

目的 :提高对胃肠道间质瘤 (gastrointestinalstromaltumor ,GIST)的认识和诊治水平。方法 :回顾分析总结 32例GIST的临床资料。结果 :患者平均年龄 4 2 .7岁 ,男女比为 17∶15。病灶均为单发 ,部位以胃及小肠最多见 ,分别为 13例 ( 4 0 .6% )和 15例 ( 4 6.9% )。病理诊断良性 2 1例 ( 65.6% )、交界性5例 ( 15.6% )、恶性 6例 ( 18.8% )。结合肿瘤临床生物学行为 ,重新划分为GIST良性 18例 ( 56.3% )、交界性 4例 ( 12 .5% )、恶性 10例 ( 31.3% )。 32例均获手术切除 ,术后复发 2例 ,肝转移 4例 ,死亡 4例。结论 :GIST是一类具有恶性倾向的肿瘤 ,局部切除是足够而有效的治疗。术后应长期严密随访 ,对复发和 /或转移者应持积极态度 ,多次姑息切除 ,辅以TACE可望延长病人生存期。

Objective To improve our knowledge and the ability of diagnosis and treatment of gastrointestinal stromal tumor(GIST).Methods The clinical data of 32 patients with GIST treated in our hospital was analyzed and summarized retrospectively.Results There were 17 males and 15 females in this group with mean age of 42.7 years.Tumors located in stomach and small bowel,taking up most part of this group,composed of 13 cases(40.6%)and 15 cases (46.9%) respectively and all tumors present lonely.Tumor were diagnosed histopathologically as benign in 21 cases (65.5%),maligant in 6 cases(18.8%),uncertain in 5 cases ( 15.5% ),but as been connected with clinicobiological behavior,They were rediagnosed as benign GIST in 18 cases (56.3%),uncertain in 4 cases (12.5%),malignant GIST in 10 cases (31.3%).All patients obtained radical or local resection of tumor and there were local recurrence in 2 cases,liver metastasis in 4 cases and death in 4 case after operation.Conclusions Local resection of primary tumor is a effective and enough measure for GIST,however,it is very necessary that long term postoperative follow up be completed for patients with GIST.Reexsection as well as auxiliary TACE may be helpful for increasing the survival time of patient with postoperative mestastasis and /or recurrence of tumor,which suggested that we hold a active attitude to manage them.