外科治疗恶性结直肠间质瘤17例报告

目的 探讨恶性结直肠问质瘤的组织学和免疫组化特点及外科治疗效果。方法 回顾性分析1990年1月-2005年3月经手术治疗的17例恶性结直肠问质瘤的临床资料和病理检查结果，分析手术切除的效果以及影响手术疗效的因素。结果 17例患者均行手术治疗，且经病理证实为恶性，其中行左半结肠切除6例，右半结肠切除3例，直肠局部切除2例，腹会阴联合切除、腹壁造口术6例．中位生存时间52．0个月，术后1、3、5年生存率分别为100％、70．6％和47．1％。结论 恶性GIST的最后诊断需依靠病理切片，CD117和CD34是确诊最有价值的依据。恶性结直肠问质瘤仍应以外科手术为主，原则上需行局部根治性切除。

Surgical treatment for malignant colorectal mesenchymoma: a report of 17 cases

Objective To evaluate the surgical treatment for patients with malignant colorectal mesenchymoma, and to analyze the clinical data, pathological features and the common presenting symptoms and its immunohistochemical staining property. Methods The clinical data and the pathological findings, including immunohistochemical staining, of 17 patients with malignant colorectal mesenchymoma admitted from Jan 1990 to Mar 2005 were retrospectively analyecd. All the patients were followed up carefully, Results All the patients underwent operation, and all the tumors were proved malignant pathologically. In 6 cases left hcmicolectomy was done, in 3 cases right hemicolectomy was done, in 2 cases the treatment was local resection from the rectum, and 6 patients received Milgs resection. The 1, 3 and 5-year overall survival rates for 17 patients with the total resection of tumor were 100%, 70. 6% and 47. 1%, respectively. The median survival time for 17 patients was 52 months. The final diagnosis of malignant GIST depended on the pathological examination, but the most worthwhile diagnostic criterion was the presence of CD117 and CD34 cells. Conclusion Since the prognosis is very poor, radical hemicolectomy is the principal treatment, and comprehensive treatment is necessary to improve clinical result.