胃肠道间质瘤的诊断与外科治疗

目的探讨胃肠道间质瘤的临床特点、诊断及治疗。方法对27例胃肠道间质瘤的临床资料进行回顾分析。结果肿瘤发生部位：胃间质瘤20例（74.1%）,小肠间质瘤5例（18.5%）,结直肠间质瘤2例（7.4%）。主要症状为腹痛、腹胀,消化道出血,腹部包块,贫血及肠梗阻。免疫组化CD117阳性23例,CD34阳性21例。全部病例均行手术治疗,无手术死亡。结论胃肠道间质瘤消化道症状无特异性,术前确诊率低,容易造成误诊;CD117和CD34阳性可作为胃肠道间质瘤诊断标志;根治性手术仍是目前G IST的首选治疗,靶向治疗将成为G IST治疗的重要手段。

Diagnosis and treatment of gastrointestinal stromal tumors

Objective To investigate clinical characteristics,diagnosis and treatment of gastrointestinal stromal tumors（GIST）.Method The clinical data of 27 patients with GIST were analyzed retrospectively.Results The tumors were situated in stomach in 20 cases,small intestine in 5 patients and colorectal region in 2 patients.The main complains of the patients were abdominalgia,abdominal distention,gastrointestinal bleeding,abdominal mass,anemia and ileus.The positive reaction by immunohistochemical methods for CD117 and CD34 was observed in 23 and 21 cases respectively.All 27 patients underwent operation for their tumors.There was no operative death.Conclusion There is low preoperative diagnosis rate and high misdiagnosis rate in GIST for their nonspecific digestive symptoms.CD117 and CD34 can be used as markers for the diagnosis of GIST.Radical surgical excision is the best therapy for primary gastrointestinal stromal tumor,targeting therapy will be the important management for GIST.