胃肠道间质瘤17例报告

目的:总结胃肠道间质瘤的诊治经验。方法:回顾性总结1996～2006年胃肠道间质瘤17例患者临床资料。结果:临床表现有消化道出血17例、腹痛16例、腹部肿块7例、肠梗阻5例;肿瘤原发于胃5例、十二指肠4例、空回肠6例、结直肠2例;镜下梭形细胞型9例、上皮细胞型5例、混合细胞型3例,良性肿瘤6例、交界性肿瘤3例、恶性肿瘤8例;免疫组化:CD117( )17例、CD34( )16例、VIM( )17例、NSE( )2例、DES( )3例、S-100( /-)2例;择期手术10例,急症手术7例,根治手术13例;随访复发10例、转移8例、死亡7例、存活10例。结论:消化道出血、腹痛、腹部肿块及肠梗阻是胃肠道间质瘤的主要临床症状,内镜和影像学检查只能提供定位诊断,确诊靠病理及免疫组化检查。根治手术切除或(和)格列卫治疗,良性、交界性肿瘤预后较好,恶性肿瘤复发转移及死亡率较高。

The report of 17 cases of gastrointestinal stromal tumor

Objective:To summarize the experience of diagnosis and treatment of the gastrointestinal stromal tumor.Methods:The clinical data of 17 patients for gastrointestinal stromal tumor from 1996 to 2006 were analyzed retrospectively.Results:The important clinical manifestations:gastrointestinal bleeding (17 cases),abdominal pain (16 cases),abdominal lump (7 cases), intestinal obstruction (5 cases).The tumor part: stomach (5 cases), duodenum (4 cases), jejunum and ileum (6 cases), colon and rectum (2 cases).The optics microscope manifestation:spindle cell type(9 cases),epithelial cell type (5 cases), the mixed cell type(3 cases), benign (6 cases),borderline (3 cases), malignant (8 cases).The immunohistochemistry:CD117( )17 cases,CD34( )16 cases,VIM( )17 cases,NSE( )2 cases,DES( )3 cases,S-100( /-)2 cases.There were 10 cases selective operation,7 cases emergency and 13 cases radical operation.Follow up: relapse(10 cases), transfer(8 cases), death(7 cases), surviving (10 cases).Conclusion:Gastrointestinal bleeding, abdominal pain, abdominal lump and intestinal obstruction are the gastrointestinal stromal tumor main clinical symptom.Optics microscope and imaging can provide the locating diagnosis, patients are exactly diagnosed by pathohistology and immunohistochemistry.Radical operation or Glivec are effective, borderline tumor has better prognosis, the malignant tumor has high ratio of relapse,metastasisrelapses and death.