直肠间质瘤11例诊治分析

目的：探讨位于直肠的胃肠间质瘤的临床特点、诊断及治疗方法。方法：对我院1995年1月～2005年12月间收治的11例直肠间质瘤的临床资料、病理及治疗进行回顾性分析。结果：11例均经手术及病理确诊，免疫组化检测CDll7、CD34阳性率分别为100％、72．7％，其临床表现无特异性。术前考虑为GIST者3例（27．3％），本组均经手术治疗，行Dixon术6例，Miles术3例，局部切除2例。经随访18～150个月，死亡2例，其余9例均存活且无复发。结论：直肠间质瘤临床少见，生物学行为多变，具有潜在恶性，手术是唯一能治愈的方法，根治性切除较局部切除效果好。

Analysis of diagnosis and treatment of 11 cases of rectal gastrointestinal stromal tumor

Objective:To discuss the clinical characteristics,diagnosis and treatment of rectal gastrointestinal stromal tumor(GIST).Methods:The clinical and pathological deta and theatment of 11 cases from January 1995 to December 2005 were analyzed retrospectively.Results:Rectal GIST were diagnosed by surgery and pathology in all cases,immunohistochemical analysis display positive reactivity for CD117(100%)and CD34(72.7%),there was no specificity on clinical presentations.Only 3 cases(27.3%)were diagnosed as rectal GIST preoperatively.All cases underwent surgical treatment,of which anterior resection of the rectum(Dixon)was performed in 6 cases,abdominoperineal resection(Miles)in 3 cases and regional resection in 2 cases.During 18 to 150 months of follow-up,9 cases survived without recurrence and 2 cases died.Conclusion:Rectal GIST has a low prevalence clinically,the biological behaviour is changeable and has potential malignancy.Surgical resection is the only curable method,the effect of radical excision is better than regional excision.It is difficult to get pathological diagnosis preoperatively.The size of tumor is the only major criterion for judgement of benign or malignancy.The tumor could be considered malignant if its diameter is more than 5 cm and mucosa has haemorrhage.