小肠间质瘤相关临床特征分析

目的 总结小肠间质瘤相关临床特征.方法 回顾性分析我科自2007年至2012年收治的31例小肠间质瘤患者的临床资料及随访资料.以腹部隐痛不适表现者7例,肠梗阻表现者8例,腹部包块表现着3例,消化道出血者11例,2例表现为纳差乏力等全身症状;术前行CT检查20例,11例诊断间质瘤,B超诊断9例,未能作出间质瘤诊断,上消化道造影3例,1例做出间质瘤诊断,内镜检查8例,4例做出间质瘤诊断;术后均行免疫组织化学检测：按照NIH分级：低风险度9例,中风险度5例,高风险度17例.结果 术后随访,复发10例,复发时间最短1个月,最长3年,中位时间18个月,复发后出现肝转移及网膜转移患者7例.结论 小肠间质瘤起病隐匿,缺乏临床特异性,术前诊断困难,术后更易复发.

Clinical features of intestinal stromal tumors

Objective To summarize the clinical features of small intestinal stromal tumors.Methods The clinical and follow-up data of 31 patients with small intestinal stromal tumors from 2007 to 2012 were retrospectively analyzed.The manifestation included abdominal pain in 7 cases,intestinal obstruction in 8 cases,abdominal mass in 3 cases,gastrointestinal bleeding in 11 cases,and general symptoms （anorexia,fatigue,etc.） in 2 cases.Twenty cases underwent preoperative computed tomography and 11 cases of them were diagnosed as stromal tumor.Nine cases underwent type-B ultrasound,but no case was diagnosed as stromal tumor.Three cases underwent upper gastrointestinal radiography and only one case was diagnosed as stromal tumor.Eight cases underwent endoscopy and 4 cases were diagnosed as stromal tumor.All of the patients underwent postoperative immunohistochemistry,and according to the classification of the National Institutes of Health（NIH）,there were 9 cases with low risk,5 cases with medium risk and 17 cases with high risk.Results During the follow-up period,10 patients relapsed and the recurrence time ranged from 1 month to 3 years,with a medium recurrence time of 18 months.Seven patients had liver and omentum metastasis after recurrence.Conclusion Intestinal stromal tumors have the features of insidious onset,absence of clinical specificity.The preoperative diagnosis is difficult and it＇s more likely to relapse after surgery.