胃镜活检和术中冰冻病理检查对胃间质瘤的诊断价值

The value of gastroscopic biopsy and fast-frozen pathology in diagnosing gastric stromal tumor

目的 分析胃间质瘤患者胃镜活检和术中冰冻病理检查的价值。方法 回顾性分析1 998年至 2 0 0 1年收治的 42例胃间质瘤患者的临床和病理资料 ,并进行随访。结果 42例中良性 2 0例 ,交界性 1 5例 ,恶性 7例。 40例行胃镜检查的患者中 1 4例取得活检 ,但仅 5例确诊 (3 5 7% ) ,另有1例疑及本病 ;2 0例患者行术中快速冰冻病理检查 ,确诊率为 40 % (8 2 0 ) ,另有 7例 (3 5 % )提示为本病。随访发现良性和交界性胃间质瘤在手术后均无复发 ,恶性胃间质瘤预后极差。结论 临床上对胃间质瘤的认识不足 ,应提高胃间质瘤术前和术中冰冻病理检查的诊断率和病变性质判断的准确性 。

Objective To evaluate gastroscopic biopsy and intro-operative fast-frozen pathology in diagnosing gastric stromal tumor. Methods Clinical and pathological materials, and follow-up documents of 42 patients with gastric stromal tumor admitted between 1998 and 2001 were studied retrospectively. Results The final pathological diagnosis of this group were benign in 20 cases, borderline in 15 and malignant in 7. Biopsy specimen were obtained in 14 out of 40 cases with gastroscopy, and diagnosis was made only in 5 cases (35.7%), and 1 case was suspected. Intro-operative resected tissues in 20 cases were examined by fast-frozen pathology, diagnosis of gastric stromal tumor was made in 8 cases (40%), and suspected in 7 (35%). No recurrence in any patient with benign and borderline gastric stromal tumor during follow-up period was found, but the prognosis for malignant one was bad. Conclusions Understanding of gastric stromal tumor is still not enough in clinical practice. The rate and accuracy of pathological diagnosis should be raised to assist management for it.