53例小肠间质瘤的临床分析

目的:探讨小肠间质瘤的临床表现、诊断及治疗。方法:对某院收治的经病理及免疫组化确诊的53例小肠间质瘤病例的临床表现、病理及诊治进行回顾分析。结果:53例SIST主要临床表现依次为:贫血,消化道出血,腹痛,腹部肿块,腹胀。免疫组化:CD117阳性率(51/53),CD34阳性率(39/53)。该组患者均行手术治疗,中位随访时间32个月(4～60个月)。32例术后复发转移,11例复发转移患者用甲磺酸伊马替尼治疗有效。结论:小肠间质瘤临床表现缺乏特异性;CT诊断小肠间质瘤检出率较高;中高恶性度SIST较低恶性度者更容易复发转移;手术为该病目前最佳选择;甲磺酸伊马替尼对手术不能完全切除及术后复发转移患者有效。

Analysis of 53 cases of Small intestinal stromal tumors

Objective ：To evaluate the clinical manifestaion and diagnosis and treatment of small intestinal stromal tumors.Methods：53 cases of small intestinal stromal tumors admitted in some hospital were diagnosed by pathology and immunohistochemistry.Tese cases were analyzed retrospectively with clinical manifestaion and pathology,and with diagnosis and treatment.Results：The main clinical manifestations of SIST included anemia,gastrointestinal bleeding, abdominal pain,abdominal mass,and abdominal distension .Based On Immunohistochemistry,CDll7-positive was seen in 51 patinets （51/53）,CD3d-positive was seen in 39 patients （39/53）.All patients were managed by surgical management）.During the follow-up of 32months （ranging from 4 to 60 months）.32 patients had postoperative reccur- rence or metastasis,but the treatment with lmatinib was effective in 11 patients.Conclusions： The clinical manifesta- tions of small intestinal stromal tumors are nonspecific. CT have a high positive rates of diagnostic for SIST.There are higher rate of recurrence and metastase in the high malignant SIST than in the low malignant SIST.The most effective therapy of SIST is operation at present.Imatinib mesylate showed good clinical efect for patients with incompletely re- sectable tumors, postoperative reccurrence or metastasis.