99例胃肠道间质瘤临床分析

目的：分析胃肠道间质瘤（GIST）的临床特征与诊断。方法：回顾性分析经手术和病理确诊的99例GIST病例资米斗。结果：1）GIST好发年龄在40岁以上，以60岁以上最多见，男性发病率多于女性。2）胃间质瘤好发于胃底和胃体。3）术前胃镜、上腹CT、超声内镜等有助于提示诊断，但最终确诊需靠术后病理及免疫组化，其中DOG-1、CDl17是目前诊断特异性较高的指标，其他CD34、SMA、S-100等可协助鉴别诊断，CEA对胃间质瘤的诊治无价值。4）手术仍是目前胃间质瘤的主要治疗方法，对于较小的肿瘤可局部切除，手术切缘距肿瘤3cm已足够；对较大的肿瘤可行胃大部切除，必要时行全胃切除；若侵及其他脏器，应争取-并切除；因淋巴结转移极少见，故不常规行淋巴结清扫。结论：GIST术前诊断较困难，确诊依赖于病理学及免疫组化检查。手术是主要治疗方法。

Clinical analysis of gastrointestinal stromal tumors in 99 cases

Objective: Analysis of clinical features and diagnosis of gastrointestinal stromal tumors.Methods: Retrospective analysis of the operation and pathology of 99 cases of gastrointestinal stromal tumors.Results: 1)The most of gastrointestinal stromal tumors occur over the age of 40,the most common With over 60 years of age.The incidengce of men than women.2)Gastric stromal tumors occur in the gastric fundus and body of stomach.3)Preoperative gastroscopy,upper quadrant CT,endoscopic ultrasound is helpful for prompt diagnosis.But eventually diagnosed by postoperative pathology and immunohistochemistry.DOG-1and CD117 is currently the diagnostic specificity of higer index.Other CD34,SMA,S-100 can assist in the differential diagnosis.CEA is no value in diagnosis of gastric stromal tumors.4)The operation is still the main treatment methods of gastric stromal tumors.the smaller tumors can be local resection.Operation margin has enough from away tumor in 3 cm.we must be subtotal gastrectomy in larger tumors.Or total gastrectomy.If the invasion of other organs.Due to lymph node metastasis is rear.It is not routine node dissection.Conclusion: G IST preoperative diagnosis is difficult.Diagnosis depends on pathologic and immunnohistochemical examinations.Operation is the main treatment method.