88例胃肠间质瘤临床诊断分析

目的探讨胃肠道间质瘤（GIST）的临床诊断方法。方法回顾性分析88例GIST患者的临床表现、影像学资料、胃肠镜、超声内镜（EUS）的结果,并进行分析、总结。结果 GIST缺乏特异性症状或体征;88例行腹部彩超发现16例病变,腹部彩超仅能发现腔外、转移病灶和少部分腔内病灶,价值不大;46例行腹部CT发现32例病变,腹部螺旋CT检查可发现较大病灶并且有助于判断胃肠间质瘤的危险性,对有无转移也有明确的诊断价值,但对于微小病灶的检出有一定困难;53例胃或结直肠病变的患者胃肠镜检查发现率为100%,但难以对病变进行定性;53例胃或结直肠病变的患者EUS误诊为其他疾病的有6例,对GIST的定性和定位有较好的辅助价值,但与病理结果之间仍有一定的出入。结论结合多种检查手段对明确GIST的诊断有重要价值,但确诊仍需病理检查。

Clinical diagnosis of 88 cases of gastrointestinal stromal tumors

Objective To investigate the value of different clinical diagnosis methods for gastrointestinal stromal tumors(GIST).Methods A retrospective study of the clinical datas of 88 patients with surgically and pathologically proved GIST was done.The data mainly includes the symptoms and signs,abdominal ultrasonography,abdominal CT,upper or lower endoscopy and endoscopic ultrasonography(EUS).Results The clinical symptoms and signs were not specific in GIST.The abdominal ultrasound found 16 lesions in 88 examinations,including a majority of extraluminal lesions and the metastasis lesions but only a small part of intraluminal lesions.The abdominal CT found 32 lesions in 46 patients.It was sensitive to find the larger lesions while not to find the smaller lesions.It was helpful to distinguish the malignant tumors from the benign.Endoscopic examination got a 100% positive rates in 51 patients with the lesions located in the stomach and colon,but it was difficult to make a etiologic diagnosis.In 51 patients with the lesions located in the stomach and colon,EUS made a right diagnosis in 45 cases,however,there were 6 false negative cases.EUS was helpful to distinguish the malignant from the benign,and to determine the origin of the lesions.Conclusion A reasonablly combined application of abdominal CT,upper or lower endoscopy and endoscopic ultrasonography before surgery is helpful to make a more perfect diagnosis of GIST,however,a defined diagnosis still needs pathological examinations.