胃肠道间质瘤的诊断和治疗

目的探讨胃肠道间质瘤的诊断及治疗。方法对1996年1月至2008年12月收治的32例胃肠道间质瘤患者的临床和病理资料进行回顾性分析。结果本组胃肠道间质瘤发生于胃25例，十二指肠3例，小肠4例；胃镜或十二指肠镜检查26例，发现病灶24例；B超、CT检查12例，诊断为胃肠道间质瘤10例。本组患者均行手术切除治疗，病理诊断为良性间质瘤15例，潜在恶性7例，恶性10例。CD117阳性表达率96.9％（31／32），CD34阳性表达率90．6％（29／32）。有26例患者术后获得6～36个月随访，未见肿瘤复发和转移。结论内镜和影像学检查是诊断胃肠道间质瘤的主要方法，CD117和CD34阳性是确诊胃肠道间质瘤的重要依据．手术切除是治疗胃肠道间质瘤的有效手段。

Diagnosis and treatment of gastrointestinal stromal tumors

Objective To review the diagnosis and treatment of gastrointestinal stromal tumor （GIST）. Methods The clinical and pathological data of 32 cases with GIST admitted from January 1996 to December 2008 were retrospectively reviewed. Results Among 32 cases of GIST, 25 were located in the stomach, 3 in the duodenum and 4 in the small intestine. Endoscopy was performed in 26 cases, lesions were found in 24 cases. B-ultrasonography and CT scan were performed in 12 cases, GIST was diagnosed in 10 cases. All patients were treated by surgical resection. Among 32 cases, 15 were benign, 7 potentially malignant and 10 malignant. The positive rates of CD117 and CD34 were 96.9% and 90.6% respectively. Twenty six cases were followed up from 6 to 36 months and no recurrence and metastasis were found. Conclusion Endoscopy and image examinations are main methods for diagnosis of GIST; CD117and CD34 expressions are most useful for the final diagnosis of GIST. Surgical resection is the effective therapy for GIST.