122例胃肠间质瘤的诊治分析及预后

Diagnosis,Treatment and Prognosis of 122 Cases of Gastrointestinal Stromal Tumors

目的：探讨胃肠间质瘤的治疗方式及预后。方法：回顾性分析我院2006年1月-2015年12月共收治的122例胃肠间质瘤患者,所有病例均行手术治疗,术后依据基因检测结果给予分子靶向治疗（格列卫）并随访。结果：所有病例经病理检查证实,其中极低恶性度7例、低恶性度37例、中等恶性度45例、高度恶性度33例,侵犯邻近组织18例,出现转移灶15例,肿瘤直径最小0.5cm,最大30cm,其中经腹腔镜手术13例,腹腔内广泛转移无法切除4例。随访104例,随访率85.2%,其中29例出现肿瘤复发（27.88%）,死亡21例（20.19%）。结论：胃肠间质瘤症状不典型,早期发现困难,提高对该疾病的认识有助于早期诊断及治疗,并能改善预后。

Objective：To investigate the treatment and prognosis of gastrointestinal stromal tumors（GISTs）.Methods：Total of 122 cases of gastroint estinal stromal tumor patients from January2006 to December 2015 in our hospital were retrospectivly analyzed.All the cases were treated with surgery and then were followed-up,and molecular targeted therapy（Gleevec）had been done according to the genetic testing after surgery.Results：All the cases had been confirmed by pathologic examination.Tumor grade included very low malignancy（7 cases）,low malignancy（37 cases）,secondary malignancy（45 cases）and severe malignancy（33 cases）;18 cases of tumor had invaded adjacent tissues and 15 cases had conformed metastatic foci.The diameters of tumors were from 0.5 cm to 30 cm.Surgical methods included laparoscopic resection of tumors（13 cases）and non-laparoscopic resection of tumors（105 cases）,and tumors in 4 cases could not be removed because of intraperitoneal extensive metastases.After surgery,104 cases（85.2%）were followed up,of which 29 cases had been discovered tumor recurrence（27.88%）and 21 cases of death had been found（20.19%）.Conclusion：GISTs have atypical symptoms and are difficult to be detected in the early period,awareness of this diseases can help to early diagnose and treat,and might improve the prognosis.