作　　者： ; ; ; ; ;

机构地区： 广州医学院附属肿瘤医院

出　　处： 《中华肿瘤防治杂志》 2008年第7期534-536,共3页

摘　　要： 目的:探讨胃肠道间质瘤(gastrointestinal stromal tumor,GIST)的临床表现、病理特征诊断和治疗措施。方法:对113例GIST患者的临床资料进行回顾性分析。结果:以消化道出血就诊者58例,上腹疼痛或腹胀45例,腹部包块7例,肠梗阻3例。肿瘤位于食管2例,胃53例,小肠47例,结肠4例,直肠7例;肿瘤体积2cm×2cm×2cm^10cm×12cm×15cm。病理检查结果:良性34例(30·1%),交界性31例(27·4%),恶性48例(42·4%);表现为梭形(43例)、上皮样(32例)或多形性(38例)。全部患者均行手术切除,手术切除不全(3例)、术后复发(8例)或远处转移(4例)的患者应用Gleevec辅助治疗。随访6个月~9年,13例患者死亡,31例术后复发,其中12例服用甲磺酸依马替尼(Gleevec)部分缓解,69例患者健在。结论:GIST临床表现主要为消化道慢性出血、上腹部不适等;消化内镜及钡气双重对比造影检查是胃及结直肠间质瘤的主要诊断方法,剖腹探查或腹腔镜腹腔探查是早期诊断小肠间质瘤的主要手段;Gleevec治疗不能完全切除或切除术后复发的GIST患者具有较好的临床疗效。 OBJECTIVE： To investigate the clinical manifestations, pathological features, diagnosis and treatment of gastrointestinal stromal tumour （GIST）. METHODS： The clinical data of 113 patients with GIST were analyzed retrospectively. RESULTS： The clinical signs of GIST were digestive duct hemorrhage in 58 cases, stomachache or abdominal distension in 45 cases, abdominal mass in 7 cases, intestinel obstruction in 3 cases. Tumor located in esaphagas in 2 cases, in gastrum in 53 cases, in small intestinel in 21 cases, in colon in 4 cases, in rectum in 7 cases. The maximum size of tumor was 15 cm× 12 cm× 10 cm, and the minimum 2 cm× 2 cm× 2 cm. Pathological examination proved that malignant stromal tumor was account for 48 cases （42.4%）, benign stromal tumor 34 cases （30.1%）, and potential types 31 cases （27.4%）. The tumor cell types were spindle cell type in 43 cases, epithelial cell type in 32 cases, polymorphous cell types in 38 cases. All of these patients were managed by operative treatment. Those patients whose tumor could not be resected completely （3 cases）, recurrence （8 cases） or metastasis （4 cases） were managed by imatinib mesylate. During the follow-up from 6 months to 9 years, 13 cases died of recurrence of gastric stromal tumor, 12 patients were part remission treating by imatinib mesylatein in 31 patients with GIST recurrence or metastasis post operation, and 69 patients survived today. CONCLUSIONS： The manifestation of GIST is digestive duct hemorrhage or stomachache and abdominal distension. Gastroduodenoscopy or gastrointestinal tract barium contrast examination is the main diagnosis measurement for these patients suspicious for gastric and rectal stromal tumor. Exploratory laparotomy or laparoscopic laparotomy is the first diagnosis choice for these patients suspicious with stromal tumor of small intestine. Imatinib mesylate has rather better clinical effect for those patients with GIST not being able to be excised completely and with metastasis or recurrence pos

关 键 词： 胃肿瘤 腔内超声检查 免疫组织化学

领　　域： [生物学]