十二指肠间质瘤15例临床分析

目的:探讨十二指肠间质瘤的诊断和治疗。方法:回顾性分析了我院1998年4月~2008年5月收治的15例十二指肠间质瘤临床资料。结果:本组病人以黑便和腹痛为主要临床症状。十二指肠间质瘤发病部位主要集中在降部和水平部。内镜超声、胃镜、X线钡餐和CT为最常用的辅助检查手段。3例行胰十二指肠切除术,7例行肿瘤局部切除术,1例行远端胃大部切除术,4例行十二指肠节段切除术。其中2例给予格列卫辅助治疗,1例术后8个月复发,6个月后死于肝转移。结论:手术切除是治疗十二指肠间质瘤有效的方法。根据十二指肠间质瘤大小和位置应采取不同的手术方式。对于免疫组化c-kit表达阳性患者术后可选择格列卫辅助靶向治疗。

Clinical Analysis of Fifteen Cases of Duodenal Gastrointestinal Stromal Tumors

Objective:To analyze the features of clinical diagnosis and treatment of duodenal gastrointestinal stromaI tumors(GIST).Methods: Clinical and pathological data of 15 cases of duodenal gastrointestinal stromaI tumors admitted between April 1998 and May 2008 in our hospital were analyzed retrospectively.Results: Melena and abdominal pain were their main symptoms.The duodenal GIST was mainly located in the 2nd(9/15)and 3rd portion of duodenum(4/15).Clinical diagnosis of the disease mainly depends on endoscopic ultrasonography,gastrointestinal endoscopy,barium meal examination,and CT scanning.Pancreaticoduodenectomy was done in three cases,local resection was done in seven cases,distal subtotal gastrectomy was done in one case,segmental resection was done in four cases.Two cases underwented adjuvant therapy with Gleevec,one of them had recurrence eight months postoperatively and died of liver metastasis fourteen months postoperatively.Conclusion: Surgical resection is the effective therapeutic method for duodenal GIST.Various surgical procedures are mainly determined by the location and size of the tumors.For the patients with c-kit positive the targeted therapy with Glivee(Imatinib) should be adopted.