30例胃间质瘤的临床诊治分析

目的探讨胃间质瘤(GST)的临床特点、病理特征、诊治方法及预后。方法回顾分析本中心30例经手术治疗和病理组织学确诊的胃间质瘤患者的临床资料。结果临床症状表现为上腹不适及疼痛21例,上消化道出血9例。行胃楔形切除术18例,近端胃大部切除术4例,远端胃大部切除术8例。病理检查:良性GST患者18例(60.00%),交界性GST患者7例(23.33%),恶性GST患者5例(16.67%)。肿瘤的核分裂相小于或等于5/50HPE和大于5/50HPE组5年生存率分别为93.50%和60.00%(P0.05)。瘤体直径小于5cm组与瘤体直径大于或等于5cm组5年生存率分别为90.00%和59.20%(P0.05)。腔内型、腔外型及混合型组5年生存率分别为80.00%、76.20%和64.70%(P0.05)。胃楔形切除术组与胃大部切除术组5年生存率分别为88.50%和80.80%(P0.05)。结论 GST临床表现以消化道慢性出血、上腹部不适等为主,良性多见。胃间质瘤的治疗以手术为主,其预后与肿瘤的核分裂相及肿瘤大小相关,与术式及肿瘤生长方式无关。

The diagnosis and treatment of gastric stromal tumor: a report of 30 cases

Objective To explore the clinical and pathological features,as well as the diagnosis and treatment of gastric stromal tumor ﹙GST﹚.Methods The clinical data of 30 cases with GST were analyzed retrospectively.Results The main symptom was abdominal pain and upper alimentary canal bleeding.Wedge resection on 18 patients and partial gastrictomies on 12 patients were performed.Pathological examination proved that benign stromal tumor was 18 cases（60.00%）,potential malignant types 7 cases（23.33%）,and malignant types 5 cases（16.67%）.The 5 year survival rate of mitotic count≤5/50HPE group and5/50 HPE group were 93.50% and 60.00%（P0.05）respectively.The 5 year survival rate for tumors5 cm and≥5 cm were 90.00% and 59.20%（P0.05）respectively.The 5 year survival rate of patiens for endogadtfic,exogastric and mixed of tumor were 80.00%,76.20%and 64.70%（P0.05）respectively.The 5 year survival rate of patiens with Wedge resection and partial gastrictomies on patients were 88.50% and 80.80%（P0.05）respectively.Conclusion The main manifestations of GST are digestive duct hemorrhage or upper stomachache and abdominal distension.Benign GST is the most common pathological type.The primary treatment of gastric stromal tumor is through surgery operation.Mitotic count and tumor size are found to be important indication of the prognosis,and the type of surgery and growth pattern of tumor do not affect the prognosis.