Long-term prognostic impact of circulating tumour cells in gastric cancer patients

AIM To analyse the long-term prognostic impact of circulating tumour cells(CTCs) in gastric cancer patients who underwent surgery. METHODS A 7.5-m L peripheral vein blood sample was obtained from each patient with treatment-negative gastric adenocarcinoma before surgery. OBP-401, a telomerasespecific, replication-selective, oncolytic adenoviral agent carrying the green fluorescent protein gene, was used to label CTCs. Correlations between the number of CTCs and clinical end points were evaluated. RESULTS The median follow-up period of the surviving patients with gastric cancer was 60 mo. The CTC number tended to increase concomitantly with disease progression. The overall survival of patients with more than five CTCs in 7.5-m L of peripheral blood was lower than that of patients with five or less CTCs, although the difference was not significant(P = 0.183). A significant difference in relapse-free survival was found between patients with more than five and those with five or less CTCs(P = 0.034).CONCLUSION A lower number of CTCs was correlated with higher relapse-free survival rates in patients. Detection of CTCs using OBP-401 may be useful for predicting prognosis in gastric cancer.

Clinicopathological characteristics and prognosis of 77 cases with type 3 gastric neuroendocrine tumours

BACKGROUND For the rarity of type 3 gastric neuroendocrine tumours(g-NETs),their clinicopathological characteristics and prognosis are not well illustrated.AIM To describe the clinicopathological features and outcome of type 3 g-NETs in the Chinese population.METHODS Based on the 2019 WHO pathological classification,the clinicopathological characteristics and prognosis of patients with type 3 g-NETs in China were retrospectively analysed.RESULTS A total of 77 patients(55.8%of females)with type 3 g-NETs were analysed,with a median age of 48 years(range:28-79 years).The tumours were mainly located in the gastric fundus/body(83.1%)and were mostly solitary(83.1%),with a median size of 1.5 cm(0.8-3.5 cm).Of these,there were 37 G1 tumours(48.1%),31 G2(40.3%),and 9 G3(11.7%).Ten(13.0%)and 24(31.2%)patients had lymph node and distant metastasis,respectively.In addition,type 3 g-NETs were heterogeneous.Compared with G1 NETs,G2 NETs had a higher lymph node metastasis rate,and G3 NETs had a higher distant metastasis rate.G1 and G2 NETs with stage I/II disease(33/68)received endoscopic treatment,and no tumour recurrence or tumour-related death was observed within a median follow-up time of 36 mo.Grade and distant metastasis were identified to be independent risk factors for prognosis in multivariable analysis.CONCLUSION Type 3 g-NETs are obviously heterogeneous,and the updated WHO 2019 pathological classification may be used to effectively evaluate their biological behaviors and prognosis.Also,endoscopic treatment should be considered for small(<2 cm),low grade,superficial tumours.

Update of Aetiological Patterns of Adult Gastric Outlet Obstruction in Accra, Ghana

Background: The aetiology of gastric outlet obstruction globally has evolved from benign to malignant causes, but there seem to be no recent data on the trends in Ghana. The aim was, therefore, to identify the current patterns in the aetiology of gastric outlet obstruction in the adult population in Ghana. Methodology: This was a retrospective review of all confirmed cases of gastric outlet obstruction in the last decade, spanning from June 2004 to May 2014, that were managed at the Korle Bu Teaching Hospital. Results: A total of 107 patients were managed for gastric outlet obstruction with a male to female ratio of 2.15:1 and most of the patients making 71.3% of cases belonged to the age range of 40 to 60 years. The predominant aetiology for gastric outlet obstruction was found to be gastric cancer (55.140%), followed by peptic ulcer disease (27.103%). Conclusion: The aetiology of gastric outlet obstruction in Ghana has evolved from benign to malignant causes, following current global trends. Gastric cancer is now the most important cause of gastric outlet obstruction in Ghana, followed by peptic ulcer disease which predominates as the commonest benign cause.

Prognostic factors of gastric cancer tumours of less than 2 cm in diameter

Objective:The aim of our study was to identify clinicopathological characteristics as predictive factors for gastric cancer tumours of less than 2 cm in diameter.Methods:The clinicopathological features of 129 patients with gastric cancer tumour of less than 2 cm in diameter were reviewed retrospectively from hospital records between 1980 and 2000.The results of retrospective analysis of clinicopathological data of 58 patients with advanced cancer were compared with those of 71 patients with early cancer.Univariate and multivariate analyses of patients with gastric cancer tumours were performed to evaluate the prognostic significance of clinicopathological features.Results:Lymph-node metastasis was found more frequently in the advanced cancer group than in the early cancer group.In univariate analysis,unfavorable prognostic factors included deep cancer invasion.Using Cox's proportional hazard regression model,only depth of invasion emerged as an independent statistically significant prognostic parameter associated with long-term survival.Conclusion:Depth of invasion is an independent prognostic factor for gastric cancer tumours of less than 2 cm in diameter.Laparoscopic surgery should not be performed on tumours that are diagnosis in advanced stage and lymph-node involvement.We recommend laparoscopic surgery involving local resection of the stomach without lymphadenectomy for small,early gastric cancer tumours.However,the validity of this recommendation should be tested by a prospective randomized control trial in the future.

Histidine decarboxylase and urinary methylimidazoleacetic acid in gastric neuroendocrine cells and tumours

AIM: To study histidine decarboxylase(HDC) expression in normal and neoplastic gastric neuroendocrine cells in relationship to the main histamine metabolite. METHODS: Control tissues from fundus(n = 3) and corpus(n = 3) mucosa of six patients undergoing operations for gastric adenocarcinoma, biopsy and/or gastric surgical specimens from 64 patients with primary gastric neuroendocrine tumours(GNETs), as well as metastases from 22 of these patients, were investigated using conventional immunohistochemistry and double immunofluorescence with commercial antibodies vs vesicular monoamine transporter 2(VMAT-2), HDC and ghrelin. The urinary excretion of the main histamine metabolite methylimidazoleacetic acid(U-Me Im AA) was determined using highperformance liquid chromatography in 27 of the 64 patients.RESULTS: In the gastric mucosa of the control tissues, co-localization studies identified neuroendocrine cells that showed immunoreactivity only to VMAT-2 and others with reactivity only to HDC. A third cellpopulation co-expressed both antigens. There was no co-expression of HDC and ghrelin. Similar results were obtained in the foci of neuroendocrine cell hyperplasia associated with chronic atrophic gastritis type A and also in the tumours. The relative incidence of the three aforementioned markers varied in the tumours that were examined using conventional immunohistochemistry. All of these GNETs revealed both VMAT-2 and HDC immunoreactivity, and their metastases showed an immunohistochemical pattern and frequency similar to that of their primary tumours. In four patients, increased U-Me Im AA excretion was detected, but only two of the patients exhibited related endocrine symptoms. CONCLUSION: Human enterochromaffin-like cells appear to partially co-express VMAT-2 and HDC. Coexpression of VMAT-2 and HDC might be required for increased histamine production in patients with GNETs.

Chemotherapy-Induced Tumour Lysis Syndrome in Gastric Adenocarcinoma with Diffuse Liver Metastases:A Case Report

Tumour Lysis Syndrome (TLS) is an important oncological emergency case which is often found together with haematological malignities and, much less often, with solid tumours. While TLS seen in solid tumour cases usually develops following a cytotoxic chemotherapy and its prognosis is poor. We present the case of a 60-year-old man with gastric adenocarcinoma with diffuse liver metastases (image shows diffuse liver metastatic lesions) and high serum LDH levels, who developed TLS after systemic chemotherapy. With urgent and proper supportive treatment (intravenous intensive hydration, sodium bicarbonate, diuretic, calcium gluconate, allopurinol and haemodialysis), an impressive recovery from TLS was achieved in the patient with an advanced stage gastric cancer. The purpose of this report is to emphasize that although the present case was a rare, high physician attention is required because significant morbidity or mortality may occur when the syndrome is not duly considered during the pre-cytotoxic evaluation of the patient, when preventive measures are not taken, or if the appropriate treatment is not applied immediately once the syndrome appears, especially in patients who have high tumour burden solid cancer.

Endoscopic ultrasonography for gastric submucosal lesions

Gastric submucosal tumors(SMTs) are a rather frequent finding,occurring in about 0.36%of routine upper GIendoscopies.Endoscopic ultrasonography(EUS) has emerged as a reliable investigative procedure for evaluation of these lesions.Diagnostic EUS has the ability to differentiate intramural tumors from extraluminal compressions and can also show the layer of origin of gastric SMTs.Tumors can be further characterized by their layer of origin,echo pattern and margin.EUS-risk criteria of their malignant potential are presented,although the emergence of EUS-FNA has opened new indications for transmural tissue diagnosis and expanded the possibilities of EUS in SMTs of the stomach.Tissue diagnosis should address whether the SMT is a Gastrointestinal stromal tumour(GIST) or another tumor type and evaluate the malignant potential of a given GIST.However,there seems to be a lack of data on the optimal strategy in SMTs suspected to be GISTs with a negative EUS-FNA tissue diagnosis.The current management strategies,as well as open questions regarding their treatment are also presented.

Immunological battlefield in gastric cancer and role of immunotherapies

Like the wars predating the First World War where human foot soldiers were deemed tools in the battlefield against an enemy, so too are the host immune cells of a patient battling a malignant gastric cancer. Indeed, the tumour microenvironment resembles a battlefield, where the patient's immune cells are the defence against invading tumour cells. However, the relationship between different immune components of the host response to cancer is more complex than an "us against them" model. Components of the immune system inadvertently work against the interests of the host and become pro-tumourigenic while other components soldier on against the common enemy – the tumour cell.

Perioperative chemotherapy for advanced gastric cancer - results from a tertiary-care hospital in Germany

BACKGROUND Neoadjuvant/perioperative chemotherapy is the recommended treatment for advanced stages of gastric cancer(>T2,N+)before tumour resection in many European guidelines.However,there is no consensus as to whether perioperative chemotherapy is as effective in distal as in proximal tumours,in addition to a relevant uncertainty concerning appropriate treatment modalities for elderly patients.AIM To investigate the role of perioperative chemotherapy in advanced gastric cancer in patients from a German tertiary clinic with respect to efficacy,localisation,and age.METHODS We performed a retrospective analysis of 158 patients from our clinic with adenocarcinoma of the stomach or the gastroesophageal junction who underwent resection between 2008 and 2016.The data were evaluated particularly in relation to patient age,tumour site,and perioperative therapy.RESULTS Administration of perioperative chemotherapy did not lead to a significant survival advantage in our study population.The 5-year survival rates were 40%for patients who received perioperative chemotherapy and 29%for the group without perioperative chemotherapy(P=0.125).Our patients were on average distinctly older than patients in most of the published randomised controlled trials.Patients elder than 75 years received perioperative chemotherapy far less frequently.Patients with a proximal tumour received perioperative chemotherapy much more often.CONCLUSION This analysis reconfirms our previous data concerning the effectiveness of perioperative chemotherapy for advanced gastric cancer.There is reasonable doubt that the quality of the existing randomized controlled trials is sufficient to generally justify perioperative chemotherapy in patients with advanced gastric cancer independent of tumour localization or age.

Primary rectal signet ring cell carcinoma with peritoneal dissemination and gastric secondaries

Disseminated signet ring cell carcinomas frequently arise from the stomach. However, primaries in the colon and rectum have also been reported. We present a 68 year old lady who presented with a change in her bowel habit. Colonoscopy showed a stenosing rectal tumour at 7 cm to 8 cm from the anal verge. Multiple scattered ulcers were also noted along the entire length of the colon. Biopsy of the lesions revealed signet ring cell adenocarcinoma. Gastroscopy showed multiple nodules with ulceration over several areas of the stomach which were similar in appearance to the colonic lesions. However, no primary tumour of the stomach was seen. Biopsy of the gastric lesions also showed signet ring cell adenocarcinoma. Computed tomography scan of the abdomen and pelvis revealed circumferential tumour at the rectosigmoid junction with possible invasion into the left ischiorectal fossa. The overall picture was that of a primary rectal signet ring cell carcinoma with peritoneal dissemination. The patient was referred for palliative chemotherapy in view of the disseminated disease. In the present report, we discuss this interesting pathological entity and review the role of various histolological techniques in helping to identify the primary tumor.

Hypoxia and its impact on the tumour microenvironment of gastroesophageal cancers

The malfeasant role of the hypoxic tumour microenvironment(TME)in cancer progression was recognized decades ago but the exact mechanisms that augment the hallmarks of cancer and promote treatment resistance continue to be elucidated.Gastroesophageal cancers(GOCs)represent a major burden of worldwide disease,responsible for the deaths of over 1 million people annually.Disentangling the impact of hypoxia in GOCs enables a better overall understanding of the disease pathogenesis while shining a light on novel therapeutic strategies and facilitating precision treatment approaches with the ultimate goal of improving outcomes for patients with these diseases.This review discusses the underlying principles and processes of the hypoxic response and the effect of hypoxia in promoting the hallmarks of cancer in the context of GOCs.We focus on its bidirectional influence on inflammation and how it drives angiogenesis,innate and adaptive immune evasion,metastasis,and the reprogramming of cellular bioenergetics.The contribution of the hypoxic GOC TME to treatment resistance is examined and a brief overview of the pharmacodynamics of hypoxiatargeted therapeutics is given.The principal methods that are used in measuring hypoxia and how they may enhance prognostication or provide rationale for individually tailored management in the case of tumours with significant hypoxic regions are also discussed.

Downregulation of TNFR2 decreases survival gene expression,promotes apoptosis and affects the cell cycle of gastric cancer cells

BACKGROUND Chronic inflammation due to Helicobacter pylori(H.pylori)infection promotes gastric carcinogenesis.Tumour necrosis factor-α(TNF-α),a key mediator of inflammation,induces cell survival or apoptosis by binding to two receptors(TNFR1 and TNFR2).TNFR1 can induce both survival and apoptosis,while TNFR2 results only in cell survival.The dysregulation of these processes may contribute to carcinogenesis.AIM To evaluate the effects of TNFR1 and TNFR2 downregulation in AGS cells treated with H.pylori extract on the TNF-αpathway.METHODS AGS cell lines containing TNFR1 and TNFR2 receptors downregulated by specific shRNAs and nonsilenced AGS cells were treated with H.pylori extract for 6 h.Subsequently,quantitative polymerase chain reaction with TaqMan®assays was used for the relative quantification of the mRNAs(TNFA,TNFR1,TNFR2,TRADD,TRAF2,CFLIP,NFKB1,NFKB2,CASP8,CASP3)and miRNAs(miR-19a,miR-34a,miR-103a,miR-130a,miR-181c)related to the TNF-αsignalling pathway.Flow cytometry was employed for cell cycle analysis and apoptosis assays.RESULTS In nonsilenced AGS cells,H.pylori extract treatment increased the expression of genes involved in cell survival and inhibited both apoptosis(NFKB1,NFKB2 and CFLIP)and the TNFR1 receptor.TNFR1 downregulation significantly decreased the expression of the TRADD and CFLIP genes,although no change was observed in the cellular process or miRNA expression.In contrast,TNFR2 downregulation decreased the expression of the TRADD and TRAF2 genes,which are both important downstream mediators of the TNFR1-mediated pathway,as well as that of the NFKB1 and CFLIP genes,while upregulating the expression of miR-19a and miR-34a.Consequently,a reduction in the number of cells in the G0/G1 phase and an increase in the number of cells in the S phase were observed,as well as the promotion of early apoptosis.CONCLUSION Our findings mainly highlight the important role of TNFR2 in the TNF-αpathway in gastric cancer,indicating that silencing it can reduce the expression of survival and anti-apoptotic genes.

Assessment of vascular invasion in gastric cancer: A comparative study

AIM: To evaluate and compare detection of lymphatic and blood vessel invasion (LVI and BVI) by hematox-ylin-eosin (HE) and immunohistochemistry (IHC) in gastric cancer specimens, and to correlate with lymph node status. METHODS: IHC using D2-40 (a lymphatic endothelial marker) and CD34 (a pan-endothelial marker) was performed to study LVI and BVI in surgical specimens froma consecutive series of 95 primary gastric cancer cases. The results of the IHC study were compared with the detection by HE using McNemar test and kappa index. The morphologic features of the tumors and the presence of LVI and BVI were related to the presence of lymph node metastasis. A χ2 test was performed to obtain associations between LVI and BVI and other prognostic factors for gastric cancer. RESULTS: The detection rate of LVI was considerably higher than that of BVI. The IHC study identified eight false-positive cases and 13 false-negative cases for LVI, and 24 false-positive cases and 10 false-negative cases for BVI. The average Kappa value determined was moderate for LVI (k=0.50) and low for BVI (k=0.20). Both LVI and BVI were statistically associated with the presence of lymph node metastasis (HE: P=0.001, P=0.013, and IHC: P=0.001, P=0.019). The mor-phologic features associated with LVI were location of the tumor in the distal third of the stomach (P=0.039), Borrmann's macroscopic type (P=0.001), organ inva-sion (P=0.03) and the depth of tumor invasion (P=0.001). The presence of BVI was related only to the depth of tumor invasion (P=0.003). CONCLUSION: The immunohistochemical identification of lymphatic and blood vessels is useful for increasing the accuracy of the diagnosis of vessel invasion and for predicting lymph node metastasis.

Tousled-like kinase 1 promotes gastric cancer progression by regulating the tumor growth factor-beta signaling pathway

BACKGROUND The role of Tousled-like kinase 1(TLK1)in in gastric cancer(GC)remains unclear.AIM To investigate the expression,biological function,and underlying mechanisms of TLK1 in GC.METHODS We measured TLK1 protein expression levels and localized TLK1 in GC cells and tissues by western blot and immunofluorescence,respectively.We transfected various GC cells with lentiviruses to create TLK1 overexpression and knockdown lines and established the functional roles of TLK1 through in vitro colony formation,5-ethynyl-2`-deoxyuridine,and Transwell assays as well as flow cytometry.We applied bioinformatics to elucidate the signaling pathways associated with TLK1.We performed in vivo validation of TLK1 functions by inducing subcutaneous xenograft tumors in nude mice.RESULTS TLK1 was significantly upregulated in GC cells and tissues compared to their normal counterparts and was localized mainly to the nucleus.TLK1 knockdown significantly decreased colony formation,proliferation,invasion,and migration but increased apoptosis in GC cells.TLK1 overexpression had the opposite effects.Bioinformatics revealed,and subsequent experiments verified,that the tumor growth factor-beta signaling pathway was implicated in TLK1-mediated GC progression.The in vivo assays confirmed that TLK1 promotes tumorigenesis in GC.CONCLUSION The findings of the present study indicated that TLK1 plays a crucial role in GC progression and is,therefore,promising as a therapeutic target against this disease.

中药左金丸逆转胃癌顺铂耐药的作用机制

目的:探讨左金丸逆转胃癌顺铂耐药的作用机制。方法:体外实验采用人胃癌细胞株SGC-7901及人胃癌顺铂耐药细胞株SGC-7901/DDP,CCK-8法检测细胞增殖率;免疫蛋白印迹法和实时荧光定量PCR法(qRT-PCR)检测左金丸干预后各组基因蛋白表达量;同时构建RTKN基因慢病毒载体转染的胃癌细胞系并验证,结合CCK-8法、qRT-PCR和Western blot法检测RTKN基因干扰对胃癌细胞顺铂耐药性的影响。裸鼠体内实验将RTKN干扰的SGC-7901/DDP细胞移植到裸鼠皮下,分别给予左金丸干预4周后,记录移植瘤大小,绘制肿瘤生长曲线,Western blot检测RTKN、p53、Ace-p53、HDAC1蛋白的表达量。结果:SGC-7901/DDP细胞中的RTKN表达量显著高于SGC-7901细胞,沉默RTKN显著降低SGC-7901/DDP细胞的耐药性;左金丸可显著降低SGC-7901/DDP细胞的耐药性,但沉默RTKN后其对SGC-7901/DDP细胞的耐药性及对裸鼠皮下移植瘤体积无明显影响,提示降低RTKN表达后,左金丸的抗肿瘤作用被抑制。结论:RTKN通过p53脱乙酰化途径增加SGC-7901/DDP细胞对顺铂的耐受性;左金丸能有效增加化疗药物对胃癌细胞增殖的抑制作用,通过抑制RTKN介导p53组蛋白脱乙酰化逆转胃癌顺铂耐药。

CDX2和MUC2蛋白表达与胃癌及癌前病变的关系

目的:研究尾型同源盒转录因子2(cau-dal-related homeobox transcription factor2,CDX2)、黏蛋白2(mucin2,MUC2)表达在胃癌及癌前病变发生发展中的作用。方法:应用免疫组织化学SP法检测,126例不同病变的胃黏膜组织中CDX2和MUC2蛋白表达。结果:126例不同病变胃黏膜组织中,CDX2和MUC2蛋白总阳性率分别为60.32%(76/126)和51.59%(65/126)。在伴肠上皮化生和伴异型增生的萎缩性胃炎组,CDX2和MUC2蛋白的阳性率显著高于不伴肠化生和(或)异型增生的萎缩性胃炎组(χ2=10.00,P=0.0016;χ2=6.029,P=0.0141;χ2=16.31,P=0.001;χ2=12.82,P=0.0003),在肠型胃癌组显著高于弥漫型胃癌组(χ2=3.9904,P=0.0458;χ2=4.8424,P=0.0278)。结论:CDX2和MUC2蛋白与胃黏膜肠上皮化生、异型增生和肠型胃癌的发生有关。

残胃癌的临床病理特点和诊治

目的探讨残胃癌临床特点及合理的外科治疗方法。方法回顾性总结本院收治的19例残胃癌患者的临床资料，分析残胃癌临床表现特点及治疗与转归。结果残胃癌平均潜伏期24．3年。全组19例患者均接受了剖腹探查，手术切除9例（47．4％）。根治性切除7例（36．8％），包括残胃全切除3例，行联合器官切除术4例：残胃加左半肝切除1例，残胃加横结肠切除1例，残胃加脾切除1倒，残胃加脾、胰尾切除1例；姑息性残胃切除、残胃空肠吻合2例，空肠造瘘5例；4例剖腹探查加置化疗泵；1例诊断性探查与活检。消化道重建术式均为Roux—en-Y吻合术。本组无住院死亡病例。14例患者获得随访，1、3、5年生存率分别为64．3％、42．9％、21．4％；7例根治性切除患者1、3、5年生存率分别为100％、85．7％、42．9％。姑息性切除患者生存时间平均为20（15～25）个月。残胃病灶未切除者生存时间平均为6．8（3～11）个月。结论胃大部分切除术后要定期进行内镜检查，可早期发现残胃癌，及时行残胃癌根治术或联合脏器切除术，可改善患者生活质量和延长患者生存期。

小胃肠间质瘤的临床病理学特征

目的 探讨小胃肠间质瘤（small gastrointestinal stromalt umors,sGIST）的临床病理学特征。方法 回顾性分析21例sGIST的临床病理学及免疫表型特征,对比分析非sGIST,并进行随访。结果 21例sGIST中女性7例,男性14例,中位年龄63岁,直径0.5-1.5cm,主要发生于胃,全部为梭形细胞型,其中9例同时伴有胃肠道恶性肿瘤。与非sGIST相比,sGIST很少出现肿瘤内出血、坏死、黏膜侵犯、溃疡及核分裂,复发风险明显低于非sGIST;免疫组化标记p53、Ki-67及肿瘤内微血管密度（microvascular density,MVD）明显低于非sGIST,差异有统计学意义（P〈0.05）。结论 sGIST可与胃肠道恶性肿瘤同时伴发,免疫组化标记p53、Ki-67及MVD均低于非sGIST,其预后较好。

检测胃癌血清和腹水中CA72-4抗原水平的临床意义

目的:对胃癌患者进行CA72-4含量的检测,分析血清和腹水中的CA72-4水平与胃癌的相关性,预期判定腹膜复发的可能性。方法:研究了48例胃癌患者血清和腹水中的CA72-4水平、损伤部位及根除和淋巴结转移的数量。结果:淋巴结转移的胃癌患者与血清和腹水中的高水平CA72-4含量显著相关。浆膜浸润胃癌与血清中的CA72-4水平含量无显著统计学相关性,然而,与腹水中的CA72-4水平含量显著相关。尽管血清中的CA72-4水平含量与晚期胃癌无显著相关性,但腹水中的CA72-4水平含量与晚期胃癌呈显著相关。结论:腹水中的CA72-4高水平含量与淋巴结转移和浆膜浸润胃癌显著相关。血清中的CA72-4水平含量仅与淋巴结转移相关,与浆膜浸润胃癌无显著相关。

胃神经鞘瘤的多层螺旋CT诊断与临床治疗

目的:探讨胃神经鞘瘤的MSCT诊断与临床治疗。方法:回顾性分析我院6例经病理证实的胃神经鞘瘤的MSCT诊断及治疗特点。结果:胃神经鞘瘤临床表现以上消化道出血多见,并无特异性。典型MSCT表现:粘膜下类圆形软组织肿块,界限清楚,表面溃疡形成,可见典型"凹陷"征象。CT增强后肿瘤多呈轻、中度强化,强化方式为持续强化。对放化疗均不敏感,治疗以手术为主,预后良好。结论:依据胃神经鞘瘤的CT图像诊断,MSCT有助于胃神经鞘瘤的定位、定性诊断,为临床手术治疗提供依据。