胃肠道间质瘤17例临床诊治分析

目的：探讨胃肠道间质瘤（ GIST ）的临床特点、治疗方法，以提高诊断和治疗效果。方法：回顾分析我院2007年1月～2012年10月17例胃肠道间质瘤患者的临床诊断、治疗、病理及随访。结果：GIST临床表现缺少特异性。17例GIST中，9例（52．9％）发生于胃，6例（35．3％）发生于小肠（其中1例伴肝脏转移），1例（5．9％）发生于直肠，1例（5．9％）发生于左半结肠系膜根部。 CT检查呈现不规则软组织肿块，大部分边界完整。 GIST免疫组织化学表达CD117阳性者16例（94．1％），CD34阳性者15例（88．2％）。2例胃间质瘤患者于术后1年死于远处转移，其余患者尚未发现明显远处转移及复发征象。结论：对于疑似GIST患者，可采用胃镜、超声胃镜、B超、CT等多种手段以明确诊断。对于确诊患者，应根据肿瘤的位置、大小等采用适合手术治疗，以降低其复发率和转移率，提高患者生存期。

Clinical Analysis of 17 Cases with Gastrointestinal Stromal Tumor

Objective：To investigate clinical characteristics , treatment methods of gastrointestinal stro-mal tumors （ GIST） to improve the diagnosis and treatment .Methods：The clinical date and follow -up of 17 patients with GIST from January 2007 to 2012 October were analyzed retrospectively .Results：The clinical mani-festations of GSIT were nonspecific.Locations of the tumor included stomach（n=9）,small intestine（n=6,in-cluding 1 case with liver metastasis ） , rectal （ n =1 ） and the root of left mesocolon （ n=1 ） .CT examination showed irregular soft tissue mass , and most of them had complete boundary .The immunohistochemical expres-sion of CD117-positive in 16 patients （94.1%）, CD34-positive in 15 cases （88.2%）.2 cases of gastric GIST patients died of distant metastasis 1 year after surgery, and the remaining patients had not yet found clear signs of distant metastasis and recurrence .Conclusions：For patients with suspected GIST , many methods can be used to confirm the diagnosis , such as endoscopic ultrasound , B ultrasound, CT etc.For diagnosed patients should be given appropriate surgery based on tumor location and size to reduce the recurrence and metastasis , and improve patient survival .