胃肠道间质瘤21例临床分析

目的:探讨胃肠道间质瘤(GIST)的诊断和治疗方法。方法:收集21例GIST临床资料,进行回顾性分析。结果:21例平均年龄56.2岁,主要临床表现为腹部胀痛、腹部包块、黑便及贫血,2例无任何不适于查体时发现。9例经超声内镜检查确诊。21例均行根治性手术,肿瘤位于胃14例,小肠5例,肠系膜2例。21例均经术后病理检查及免疫组化确诊GIST,免疫组化表型以CD117、CD34阳性率较高。根据Miettinen等原则分类,良性5例,低度恶性10例,中等度恶性3例,高度恶性3例。结论:GIST的术前诊断有赖于纤维内镜、超声内镜、B超、CT等检查的综合应用,病理检查及免疫组化表型分析是确诊金标准,手术切除是最有效的治疗手段。

The Clinical Analysis of Gastrointestinal Stromal Tumor: a Study of 21 Patients

Objective:To investigate the diagnosis and treatment of gastrointestinal stromal tumor(GIST).Methods:The clinical data of 21 patients with GIST were analysed retrospectively.Results:21patients were included in this group with mean age of 56.2 years.The main clinical manifestations were abdominal distending pain,abdominal mass,melena and anemia.2 patients were diagnosed in the somatoscopy without any syndrome.9 patients were diagnosed by the ultrasonic microscopy.All patients were treated with radical resection.The tumors were located in stomach with 14 patients,in small intestine with 5 patients and in mesentery with 2 patients.All patients were diagnosed by the pathology and immunohistochemistry.The main immunohistochemical positive findings were CD117 and CD 34.According to the Miettinen classification,five patients were of benignancy,ten of low risk,three of intermediate risk,and three of high risk.Conclusion:The diagnosis of GIST depends on the microscopic appearance,uitrasonic microscopic appearance,ultrasonic wave and CT,combined with immunohistochemical inspection.Resection of tumors is the most effective treatment for GIST.