胃肠道间质瘤诊断与治疗

目的探讨胃肠道间质瘤的诊断、治疗及预后。方法回顾性分析1995年1月～2005年4月收治的23例胃肠道间质瘤的诊治情况,并应用4种抗体(C-Kit、CD34、SMA、S-100)通过免疫组化方法进行分析研究。结果所有病例均行手术治疗,其中17例行完整手术切除治疗,手术切除率为73.9%,C-Kit 阳性表达率91%,CD34阳性表达率85%,患者均未辅以化疗,18例随访5年以上,5年生存率为56%。结论 C-Kit 和 CD34标记阳性是确诊胃肠道间质瘤最有价值的诊断依据,手术是主要治疗手段,术中的正确判断对指导术式选择也至关重要。对无法手术切除和(或)肿瘤复发、转移的患者建议应用格列卫。

Diagnosis and Treatment of Gastrointestinal Stromal Tumors

Objective To study the diagnosis, treatment and prognosis of Gastrointestinal stromal tumors. Methods A retrospective study was conducted on 23 patients with Gastrointestinal stromal tumors from Jan. in 1995 to Jvly.2005. by immunohistochemistry with antibody regimes including C-Kit, CD34, SMA and S-100. Results All cases was undergone operation, seventeen cases were performed by radical surgery, and the resection rate was 73.9% .Immunohistochemical results showed C-Kit( )in 91% cases, CD34( )in 85% cases.None was giv- en postoperative chemotherapy. The five-year survival rate was 56%. Conclusions Pathological examination and immunohistochemical result in- cluding C-Kit( )and CD34( )are unique method for diagnosis of GIST. Total removing the tumor is the most effective measuree for the patients, right judgement in operation maybe the key to choose operation way and its range. Giivec is beneficial to the patients with unresectable, residual or recurrent tumor.