胃间质细胞瘤18例诊治分析  

Diagnosis and treatment of gastric stromal tumor: a report of 18 cases

作　　者：熊炳贤[1] 李红浪[1] 曾飞[1] 常耿 

机构地区：[1]江西医学院第二附属医院普外科,江西南昌330006 [2]江西省恒湖医院,江西南昌330000

出　　处：《中国普通外科杂志》2004年第9期670-672,共3页China Journal of General Surgery

摘　　要：目的　探讨胃间质细胞瘤的诊断和治疗。方法　对胃质细胞瘤 18例临床资料进行回顾性分析。 18例均经手术证实病理确诊。胃楔形切除 2例 ,胃部分切除 5例 ,胃大部切除 9例 ,全胃切除加局部淋巴结清扫 2例。结果　该病多见于 40岁以上成人 ,以胃体和腔内型生长为多 ,分别占5 5 .5 %和 61.1%。术前诊断率 2 7.8% ,误诊率 72 .2 %。手术切除率 10 0 % ,无手术并发症和手术死亡。 15例术后随访 1～ 10a ,2例死于肿瘤复发转移 ,其余均存活。结论　该病缺乏特异临床表现 ,术前诊断较难。X线钡餐和胃镜检查是主要辅助诊断手段 ,结合组织学和免疫组化检查有助于确诊。手术切除是惟一有效的治疗方法。Objective To investigate the diagnosis and treatment of gastric stromal tumor(GST). Methods Retrospective analysis was made on the clinical data of 18 cases of GST. The diagnosis of 18 cases was confirmed by pathology. Local resection of the tumor was performed in 2 cases,partial gastrectomy in 5 cases, subtotal gastrectomy in 9 cases, and total gastrectomy with lymph node clearance in 2 cases. Results Most of the patients were over forty years old.In 55.5% of cases,the location of tumor was at the middle of the stomach,and 61.0% of cases were intragastric growth type.The preoperative diagnostic rate was 27.8%,misdiagnostic rate was 72.2%.The resectability rate was 100%. No postoperative complications and operative death occurred in this series. Fifteen cases were followed up for 1 to 10 years. During follow up,2 cases died of recurrence of the tumor, and the other patients were still alive. Conclusion The GST patients lack typical clinical manifestations, and the preoperative diagnosis is difficult.Barium meal examination and gastroscopy are the main supplementary examinations.A combination of histological and immunohistochemical examinations is helpful to confirm the diagnosis.Surgical resection is the only effective therapeutic method.

关 键 词：胃肿瘤 间质细胞瘤 

分 类 号：R735.2[医药卫生—肿瘤] R730.262[医药卫生—临床医学]