26例胃肠间质瘤临床诊治中的体会

目的:探讨胃肠间质瘤(gastrointestinal stromal tumor,GIST)诊治经验。方法:回顾分析川北医学院附属医院2006年1月至2010年12月收治经病理证实的26例GIST病人的临床诊治过程中的资料。结果:常规腹部彩色多普勒超声在初诊中漏诊4例,CT、MRI均发现肿块;术后测量肿块大小皆大于2.0 cm;1例放弃治疗,25例采取开腹手术,未采取新辅助化疗及其术后辅助化疗,2例因腹腔广泛转移,采取姑息治疗,术后骨髓病理学证实有骨髓转移,22例完整切除。结论:常规胃肠镜及B超在诊断GIST中存在局限性,CT或MRI能较超声提高临床诊断率,但通过找到一种标志物能早期诊断直径小于2.0 cm的GIST需要进一步研究。

Experience in clinical diagnosis and treatment of gastrointestinal stromal tumors(GIST):report of 26 cases

Objective:To study the experience in the diagnosis and treatment of gastrointestinal stromal tumors(GIST).Methods: The clinical diagnosis and processed treatment data of 26 cases(proved pathologically) were admitted from January 2006 to 2010 December to the Affiliated Hospital of North Sichuan Medical College and were analyzed retrospectively.Results: Four cases were missed by the conventional abdominal color Doppler ultrasound in the first visit.By using CT or MRI,no patients were missed;Postoperative measurements of tumor size were more than 2.0 cm.One patient gave up treatment and the remaining 25 cases underwent open surgery,but were not given any adjuvant chemotherapy.Two patients with widespread metastatic abdominal tumors received palliativecare by bone marrow pathology confirming the transfer.Twenty-two patients were treated with complete resection.Conclusions: In the diagnosis of GIST,endoscopy and B-ultrsound have some limitations,Either CT or MRI can improve the diagnosis.However,a tumor-marker for early diagnosis of GIST with a diameter less than 2.0 cm.further investigatation is needed.