贲门胃底平滑肌瘤和平滑肌肉瘤的临床分析

为了研究和认识贲门胃底平滑肌肿瘤的临床特点、检查方法、治疗方式以及影响预后的因素，本文回顾性分析我院外科手术并病理证实的14例贲门胃底平滑肌肿瘤，其中肌瘤10例，肉瘤4例。主要症状是上腹部疼痛不适和反复黑便，无吞咽困难和梗阻。术前造影和胃镜检查基本可明确诊断。平滑肌肉瘤预后不佳。贲门胃底平滑肌瘤和肉瘤的区别主要在病理上核分裂数、瘤细胞坏死以及临床上肿瘤大小，而手术切除范围并不明显影响存活率。

A clinical analysis of leiomyoma and leiomyosarcoma of cardia and fundus of stomach

In order to evaluate and understand the clinical manifestations,methods of examination,treatment and factors influencing the prognosis of leiomyoma and leiomyosarcoma of cardiaand fundus of stomach were carried out in 14 cases of them with operation and a retrospective analysis of pathological confirmation of which 10 cases were leiomyoma and 4 leiomyosarcoma was carried out,too. The most common symptoms were epigastric pain and discomfort as well as recurrentmelena, no dysphagia or obstruction. Preoperative X-ray and gastroscopic examinations neally almost basically made the diagnosis clear for this series. Leiomyosarcoma was poor for even proximalsubtotal gastrectomy or total gastrectomy was performed. The main differentiation between leiomyoma and leiomyosarcoma depended upon numbes of pathological mitoses, necrosis of tumor cell, and clinically the size of the tumor. The extent of resection did not obviousely affect the survival rate for leiomyosarcoma.