胃肠道间质瘤32例临床诊治体会

目的：探讨胃肠道间质瘤的临床表现、诊断及治疗。方法：分析山西省肿瘤医院普外科2004年3月至2010年3月间收治的胃肠道间质瘤32例患者的临床及病理资料。结果：32例均经手术治疗。病理诊断良性8例（25%）,交界性7例（21.8%）,恶性17例（53.2%）。CD117阳性31例（96.9%）,CD34阳性27例（84.4%）。随访时间5个月至5年,8例出现远处转移或局部复发,5例死亡。结论：胃肠道间质瘤在中老年好发,以便血、腹痛和腹部不适、腹部包块表现为主。病理形态学检查是确诊间质瘤的唯一方法。治疗以手术为主,对无法切除或有肿瘤残余及术后复发的患者可应用甲磺酸伊马提尼（格列卫）进行治疗。

Clinical Analysis of Diagnosis and Treatment on 32 Cases with Gastrointestinal Stromal Tumor

Objective: To study the clinical manifestation,diagnosis and treatment of gastrointestinal stromal tumor（GIST）.Methods: The clinical and pathological data of 32 cases with GIST in Shanxi Tumor Hospital from Mar.2004 to Mar.2010 were analyzed.Results: Among 32 cases who were operated on,benign GIST was in 8 cases（25%）,borderline GIST in 7 cases（21.8%）,and malignant GIST in 17 cases（53.2%）.Immunohistochemical results showed CD₁17（+）（96.9%）in 31 cases and CD₃4（+）（84.4%） in 27 cases.The cases were followed-up from 5 months to 5 years.8 of them had local recurrence and metastasis and 5 cases died.Conclusion: GIST occurrs in aged patients frequently with clinical manifestation of gastrointestinal bleeding,abdominal pain or discomfort and abdominal mass.Pathological examination is the unique method for diagnosis of GIST and the operation treatment is the main choice.Imatinib mesylate is beneficial to the terminal stage patients with unrecstable,residual or recurrent tumor.