胃肠道间质瘤15例临床分析

Gastrointestinal stromal tumors:clinical analysis of 15 cases

目的 探讨胃肠道间质瘤的临床表现、诊断、治疗和预后。方法 回顾性分析 1999年 4月至 2 0 0 2年 7月收治的 15例胃肠道间质瘤的临床和病理资料。结果 主要临床表现为腹部不适 (7/ 15 )、消化道出血 (6 / 15 )。病变部位为胃 13例 ,十二指肠 1例 ,小肠 1例。 14例行手术治疗。 15例镜下均见梭形细胞 ,其中良性 9例 ,交界性 4例 ,恶性 1例 ,胃癌伴良性间质瘤 1例。免疫组化CD117(+) 73% ,CD34(+) 73% ,SMA(- ) 73% ,S - 10 0 (- )6 7%。随访率 10 0 % ,病人均存活。结论 内镜和影像学检查是发现胃肠道间质瘤病变的主要手段 ,术前确诊仍较困难 ,手术切除是病理确诊和治疗的主要方法。

Objective To study the clinical manifestation, diagnosis, treatment and prognosis of gastrointestinal stromal tumors (GISTs). Methods Clinical and pathological data of 15 cases of GISTs from Apr 1999 to July 2002 were retrospectively analyzed. Results The most common clinical presentations were abdominal pain or discomfort (7/15) and gastrointestinal bleeding(6/15).The tumor sites were 13 in stomach,1 in duodenum and 1 in small intestine.Fourteen cases were operated.Fusiform cells were found with microscope in 15 cases.Among the tumors,9 were benign,4 in the borderline,1 malignant and 1 gastric cancer complicated with benign stromal tumor.Immunohistochemical results were CD117(+)73%,CD34(+)73%,SMA(-)73% and S-100(-)67%.All patients were followed up and they all survived.Conclusion Endoscopy and imaging examination are main methods to detect GISTs.Preoperative diagnosis is still difficult;surgical resection is the main method for pathologic diagnosis and treatment.