胃肠道间质瘤伴肝脏转移的外科诊治分析

目的探讨胃肠道间质瘤（GIST）伴肝脏转移的临床病理特征、外科治疗及预后。方法回顾性分析2001年3月至2006年8月间手术治疗的6例晚期GIST伴肝脏转移患者的临床病理资料。结果本组6例均采用手术切除治疗，术后免疫组化检查CD117均为阳性。其中5例手术完整切除原发肿瘤及可见转移灶，1例手术姑息切除并辅以术中及术后局部介入治疗。术后随访6～66个月（平均生存27．5个月），1、2、5年分别生存5、3、1例。术后发生复发转移3例，1例行转移灶切除，其他2例分别带瘤存活14及18个月。结论原发灶及转移灶的完整切除辅以术中和术后局部介入治疗是治疗GIST伴肝脏转移的首选和有效疗法；GIST远期仍存在较高的复发转移率，但患者仍有希望长期带瘤生存。

The diagnosis and treatment of gastrointestinal stromal tumors with hepatic metastases

Objective To investigate the clinicopathological features,surgical treatment,and prognosis of gastrointestinal stromal tumors (GIST) with hepatic metastases. Methods The clinicopathological data of 6 patients admitted from May 2001 to Aug 2006 diagnosed as advanced GIST with hepatic metastases were analyzed retrospectively. Result Primary tumors and hepatic metastases were completely resected in 5 cases.One case received palliative resection followed by interventional therapy. Postoperatively,all patients were followed up from 6 to 66 months(mean 27.5 months).The postoperative 1,2,and 5 year's survivors were respectively 5 case,3 case and 1 case.During the follow-up,3 cases suffered from tumor recurrence and metastases.One underwent tumor resection,and the other two cases survived for 14,and 18 months respectively after the diagnosis of recurrence. Conclusion Complete resection of primary tumors and metastatic lesions are the effective treatment for GIST with hepatic metastases.Patients can survive with recurrent tumors for a comparative long time.Tumor resection along with chemotherapy and interventional therapy prolongs patient's survival.