小肠间质瘤18例分析

目的:探讨小肠间质瘤的诊断和治疗方法。方法:回顾性分析18例小肠间质瘤患者的临床资料。结果:18例患者平均发病年龄46.6岁,病程5h~2年。主要临床表现为黑便、腹痛、腹部肿块、腹胀不适、贫血、体重下降等。发生部位:空肠12例,回肠5例,空回肠多原发性1例。B超检查13例提示腹腔肿块,其中10例提示来源于肠道,3例不能提示来源。CT增强及血管三维成像均发现肿瘤或转移病灶,其中15例定位于肠道肿瘤(83.3%)。手术后获得0.5~6年的随访,复发3例,2例广泛转移死亡。结论:空回肠间质瘤缺乏特征性临床表现,B超和CT对诊断有帮助,手术及分子靶向治疗是有效方式。

Diagnosis and Treatment of Small Intestinal Stromal Tumor

Objective To study the diagnosis and treatment of small intestinal stromal tumor （SIST）. Methods The clinical information of 18 patients with SIST was retrospectively analyzed. Results The average age of the patients was 46.6 years. The main clinical manifestations included dark stools, abdominal pain, abdominal mass, abdominal distention and loss of bodyweight. The tumors were located in the jejunum in 12 cases, in the ileum in 5 cases, and 1 patient had multiple tumors in both the jejunum and ileum. The abdominal mass was discovered by B-ultrasonogrphy in 13 patients. Among them, 10 cases were diagnosed with the tumor located in intestinal tract, in 3 cases the origin of the tumor could not be determined. CT scan showed all discovered to have primary tumors or metastatic lesions. In 15 cases the tumors were indicated to be located in the intestinal tract （83.3%）. Diagnosis was confirmed as stromal tumor by pathology and immunohistochemistry. All 18 patients were followed up from 5 months to 6 years, 3 patients had recurrence, 2 hepatic metastases, and 2 died. Conclusion The stromal tumors of jejunoileum lack distinctive clinical manifestation, CT and B-ultrasonography can be benefit in diagnosis. Operation and molecular targeted therapy are effective treatment of SIST.