31例胃肠间质瘤临床分析

Clinical Analysis of 31 Gastrointestinal Stromal Tumors Cases

目的:探讨胃肠间质瘤的诊断及治疗特点。方法:回顾性分析31例胃肠间质瘤患者的临床病理结果及治疗方法。31例患者全部行手术治疗,术后行病理及免疫组织化学诊断,中高危险度患者予以伊马替尼治疗。结果:31例中24例为胃间质瘤,7例为小肠间质瘤,其中CD117阳性28例,CD34阳性26例,S-100阳性表达6例,SMA阳性表达7例。根据Fletcher分级,极低度危险组7例,低度危险组14例,中度危险组4例,高度危险组6例。2例中高危险度患者未规律服药出现复发及转移。结论:胃肠间质瘤确诊需行临床病理及免疫组化检查,主要病理学依据为CD117,外科手术是首选治疗。

Objective To explore the clinical characteristics of diagnosis and therapeutic strategies of gas-trointestinal stromal tumors （GIST）. Methods Thirty one patients with GIST were retrospectively analyzed, in-cluding the clinical manifestations ,diagnosis and treatment. All patients undertook surgery and the final diagno-sis was based on postoperative pathology and immunohistochemistry. The patinets in intermediate risk and high risk were treated with imatinib after surgical resec-tion. Results Twenty four cases were gastric stro-mal tumors, seven cases were small intestinal stromal tumors.CD117 was positive in twenty eight cases, CD34 was positive in twenty six cases,S-100 was positive in six cases,SMA was positive in seven cases. Accord- ing to Fletcher risk classification,the patients of extremely-low risk,low risk,intermediate risk,and high risk were seven cases,fourteen cases,four cases,and six cases respectively. Ten cases（four cases in intermediate risk, and six cases in high risk ）were treated with imatinib after surgical resection. Two cases in intermediate risk and high risk were found to present local recurrences and metastasis because of irregular imatinib treatment. Conclusion The final diagnosis of gastrointestinal stromal tumors can be based on postoperative pathology and immunohistochemistry detection, mainly depended on CD117. Surgical resection is the preferred treatment.