胃肠道间质瘤27例临床分析  

The Diagnosis and Treatment on Gastrointestinal Stromal Tumors

作　　者：汤衍斌[1] 马涛[1] 江小琼[1] 邹远航[1] 付世艳[1] 孙淑明[1] 

机构地区：[1]汕头大学医学院第一附属医院,广东汕头515041

出　　处：《实用医技杂志》2006年第13期2310-2311,共2页Journal of Practical Medical Techniques

摘　　要：目的:探讨胃肠道间质瘤(GIST)的临床特点及诊断治疗。方法:收集我院27例GIST的临床资料进行回顾性分析。结果:本组平均发病年龄48.6岁。发生部位分别为:胃13例(48.1%),空肠7例(25.9%),回肠5例(18.5%),十二指肠、结肠各1例(各3.7%)。本组病例术前均未能确诊。27例均行外科手术切除,病理证实良性21例(77.8%),恶性6例(22.2%)。肿瘤的大小与良恶性相关(P<0.05)。术后随访:良性GIST18例,平均随访时间24.6个月,16例无局部复发、转移;2例术后1年内复发再手术;恶性GIST6例,平均随访26.4个月,3例局部复发再手术,1例肝肺转移:2例死亡。5例恶性GIST术后辅以不规则化疗,但生存期未见明显变化。结论:GIST消化道症状无特异性,术前确诊率低。肿瘤的大小是判断良恶性GIST的重要指标。目前间质瘤的治疗仍以手术切除为主,对复发或远处转移者应积极再次手术,可延长生存期。Objective To investigate the diagnosis, treatment and clinical features of gastrointestinal stromal tumors （GIST）. Methods We retrospectively analyzed 27 patients with GST treated in affiliated hospital of guangdong medical college. Results There were 1 8 males,11 famales with average age of 49.5 years. Tumors located in the stomach in 13 cases（48.1%） ,jejunum in 7 cases（25.9%）,ileum in 5 cases（18.5%）,and duodenum,mesentery of small intestine,colon and rectum in 1 case（3.7% ）respectively. The commonest symptoms were abdominal pain and abdominal distention （65.5%） ,alimentary tract bleeding（44.8%）. We had only a rectum stromal tumor in 1 case diagnosed before operation. All the 27 patients were treated surgically. Histoiogy diagnosed as benign humor in 21 cases（77.8% ） ,malignant in 6 cases（22.2% ）. The size of tumors was correlated with the malignancy Of GIST significantly（P〈0.05）. Benign GIST in 1 8 cases were followed-up for average 24.6 months, 16 of them had no local recurrence and metastasis,2 cases of them relapsed and operated again. Malignant GIST in 6 cases were followed-up for average 26.4 months,3 of them with local recurrence were treated with re-operation, 1 case of them had liver and lung metastasis, and 2 cases died. Malignant GIST in 5 postoperative cases had been irregularly retreated by chemotherapy,however, the survival period of these patients was not be prolonged. Conclusion The confirmed diagnosis rate of preoperative-GIST is low and digestive tract symptoms have no specific. The size of the tumor is the important marker to the diagnosis of benign of malignant GIST. At present ,the operation is still the main method to treat GIST. For recurrent or metastatic cases re operation can prolong patients＇life.

关 键 词：胃肠道 间质瘤 临床分析 

分 类 号：R735[医药卫生—肿瘤]