胃间质瘤的临床分析——附27例报告

目的探讨胃间质瘤（GSTs）的临床特点、诊断治疗方法及预后。方法回顾性分析我院2003年1月-2008年12月6年间收治的27例胃间质瘤患者的临床和病理资料。结果本组27例（100％）病理形态均为梭形细胞。免疫组织化学检查示：CD117的阳性率为96．3％（26／27），CD34的阳性率为88．9％（24／27）。主要临床表现为腹部不适（12例）、黑便（9例）、腹部肿块（6例）。病变部位在胃体（17例）、胃底（6例）、贲门（3例）、胃窦（1例）。全组均行手术治疗，无手术死亡病例，术后20例随访1个月-5．5年，复发转移2例，复发后口服甲磺酸伊马替尼治疗1例。结论病理检查及免疫组化是诊断胃间质瘤的必要手段。外科手术是胃间质瘤的主要治疗方法。适当的甲磺酸伊马替尼治疗可以改善GSTs患者预后。

Clinical analysis of gastric stromal tumors: report of 27 cases

Objective To discuss the clinical characteristics of gastric stromal tumors （GSTs）, as well as their diagnosis and therapeutics. Methods, The clinical and pathological data of 27 cases of GSTs admitted to our hospital from Jan. 2003 to Dec. 2008 were retrospectively analyzed. Results The microscopic pathological morphology were exclusively fusiform cells in 27 cases （ 100% ）. Immunohistochemical determination revealed that the positive rate of CD117 and CD34 was 96.3% and 88.9%, respectively. The chief clinical manifestations included abdominal pain or discomfort （12/27）, gastrointestinal bleeding （9/27） and abdominal mass （6/27）. The tumor sites were situated in the body of stomach （17）, fundus （6）, cardia （3） and the gastric antrum （1）. All the cases underwent surgical procedures, with no operative deaths. During the postoperative follow - up tangoing from 1 month to 5.5 years, recurrence and metastasis occurred in 2 cases, 1 of whom was treated with oral Glivec after recurrence. Conclusions Pathological and immunohistochemical techniques are essential to the diagnosis of GSTs. Surgical operation is the main means to treat GSTs. Appropriate treatment with Glivec can improve the prognosis of patients with GSTs.