胃肠道间质瘤的临床分析

目的探讨胃肠道间质瘤的临床诊断与治疗。方法回顾性分析95例胃肠道恶性间质瘤病人的临床资料。结果发生于胃、小肠、结直肠、肠系膜、大网膜的病例分别为65、25、2、2、1例；肿瘤直径1～10cm；其中恶性者47例，良性者48例；行根治性切除62例，行切除术31例，2例广泛转移者行肝结节活检。17例术后发生伤口感染，免疫组化指标：CD117、CD34、CK、EMA、S-100及Desmin阳性率分别为89．5％、86．3％、5．3％、0、9．5％及8．4％。随访80例，2例胃间质瘤广泛转移者分别于术后4月、6月死亡，17例术后5～25月死于其他疾病，余者均无瘤生存，5年生存率43．7％。结论提高对胃肠道间质瘤的认识，强化术中病理学检查及免疫组化检查，确定良恶性及恶性程度，采取合理规范的手术方式，对预后及防止复发有一定意义。

Clinical Analysis of Gastrointestinal Stromal Tumor

Objective To investigate the clinical diagnosis and treatment of gastrointestinal stromal tumor(GIST). Methods Ninety-five cases of GIST were retrospectively reviewed. Result The location of tumor were stomach, intestine, colon, mesentery and omentum in 65, 25, 2, 2 and 1 case respectively, including malignant in 47 cases, benign in 48 cases. Tumor sizes were 1 to 10 cm in diameter. Surgical treatment included radical resection in 62 cases, local resection in 31 cases, hepatic lesion biopsy in 2 cases due to diffuse intrahepatic metastasis. Postoperative wound infection occurred in 17 cases. Immunohistochemistry staining presented positive rate of CD117, CD34, CK, EMA, S-100 and Desmin were 89.5%, 86.3%, 5.3%, 0, 9.5% and 8.4% respectively. Eighty cases were followed up to date, which showed 2 cases of extensive metastasis died 4 and 6 months postoperatively, 17 cases died with no relation to the primary disease. The rest cases survived with tumor-free, the 5-year survival rate was 43.7%. Conclusion Improved understanding of GIST, intensified intra-operative pathological and immunohistochemistry examination, and reasonable operation demonstrate significance in preventing recurrence and improve prognosis.