胃肠道外间质瘤的临床特征、治疗与预后

目的探讨胃肠道外间质瘤（EGIST）的临床特征、治疗与预后。方法收集2000年1月-2005年12月诊治的EGIST共21例，并对其临床资料进行回顾性分析。结果本组21例的EGIST最主要的临床表现为发现腹部包块，腹痛。肿瘤原于肠系膜或网膜10例，腹膜后11例，浸润邻近器官7例，伴有远处转移5例。免疫组化染色结果：CD117、CD34、Desmin、Actin、S-100、NSE阳性率分别为90％、71％、5％、33％、19％、5％，与胃GIST免疫组化结果比较差异无统计学意义（P〉0．05）。本组11例行完整切除术，6例为不全切除术或肿瘤减灭术，4例肿瘤未能切除。19例患者获得随访，12例死亡，中位生存时间20个月。EGIST预后与核分裂数、肿瘤大小、肿瘤浸润邻近器官或远处转移、肿瘤是否完整切除有关（P〈0．05）。结论EGIST与GIST有相似的免疫组化染色特点，EGIST恶性程度高，预后比胃GIST差。完整切除肿瘤有助于延长患者生存时间，术后应长期随访。

The clinical characteristics, treatment and prognosis of exra-gastrointestinal stromal tumors

Objective To explore the clinical characteristics,treatment and prognosis of extra- gastrointestinal stromal tumors (EGIST).Methods The clinical data of EGIST 21 cases admitted from January 2000 to December 2005 were analyzed retrospectively. Results There were 11 males and 10 females,the median age was 61 years.Palpable mass and abdominal pain were among the most common clinical manifestations.Tumor originated from mesentery or omentum in 10 cases,from retroperitoneum in 11 cases,invaded adjacent organs in 7 cases,and metastasized in 5 cases.Immunohistochemically, CD117,CD34,Desmin,Actin,S-100,and NSE was positive in 90%,71%,5%,33%,19%,5%, respectively,which were not significantly different from what would be with gastric GIST (P>0.05). Eleven patients underwent cmnplete resection,6 did palliative resection and 4 did laparotomy only.19 cases were followed-up with 12 deaths,and the median survival time was 20 months.Univariate analysis indicated that the prognosis of EGIST was correlated with mitotic count,tumor size,tumor invasion of adjacent organs or metastasis,and incomplete resection (P<0.05). Conclusions EGIST has similar immunohistochemical staining features with GIST and poorer prognosis than gastric GIST.Complete resection may prolong survival time,and long-time following-up should be proposed after operation.