胃肠道间质瘤的诊断与治疗分析

目的探讨胃肠道间质瘤（GIST）的诊断及治疗方法。方法回顾性分析2002年1月至2006年12月经手术后病理证实的GIST42例临床资料。结果肿瘤位于胃部20例，十二指肠4例，小肠16例，直肠2例。其中33例达到外科根治性切除。2例因肿瘤广泛转移行姑息切除。7例伴肝转移者中2例行原发灶及转移灶切除，5例不能切除的肝转移灶，术后辅以药物治疗。术后平均随访22个月，33例中术后复发转移9例，复发间期平均14个月，其中7例再次手术治疗，其他2例分别带瘤生存12及16个月。结论外科手术切除原发灶及肝转移灶是治疗GIST的首选有效方法，不易切除的肝转移灶，术后应辅以药物治疗。GIST远期仍存在较高的复发转移率。对复发转移病例，仍应争取再手术治疗。

The diagnosis and treatment of gastrointestinal stromal tumor (GIST)

Objective： To investigate the diagnosis and treatment methods of gastrointestinal stromal tumors （GIST）. Methods： In the study, 42 clinical cases with pathologically proved GIST at our hospital from January 2002 to December 2006 were retrospectively analysed. Resuhs： The tumors originated respectively from the stomach （n = 20）, the duodenum （n = 4） , the intestine （n = 16）, and the rectum （n = 2）. Thirty-three cases received curative resection. Two cases underwent palliative resection because of extensive metastasis. In 7 cases of hepatic metastases, two cases of primary tumors and hepatic metastases were reseeted, and five cases which were not reseeted of the hepatic metastases were followed by medicine after operation. Postoperative recurrence or metastasis of GIST was found in 9 cases during an average follow - up of 22 mos with the average latency of 14 mos. Seven recurrent cases received reoperation, and the other two cases survived for 12, and 16 months respectively after the diagnosis of recurrence. Conclusion： Complete resection of primary tumors and metastatic lesions are the effective treatment for GIST. If the hepatic metastases were not resected, medicine should follow after operation. GIST patients can survive with recurrent tumors for a comparatively long time. Reoperation may prolong the survival of patients with GIST who suffer from postoperative recurrence.