胃肠道间质瘤肝转移临床病理分析并文献复习  

The clinicopathological analysis of gastrointestinal stromal tumors with hepatic metastasis and a review of literature

作　　者：刘庆猛[1] 孙凤平[1] 

机构地区：[1]浙江绍兴第二医院病理科,浙江绍兴312000

出　　处：《中国癌症杂志》2008年第7期513-516,共4页China Oncology

摘　　要：背景与目的:胃肠道间质瘤(GIST)肝转移及再发转移的治疗和预后文献报道不多,本研究总结GIST肝转移及再发转移的临床病理特征及治疗预后情况。方法:对2例GIST肝转移病例的临床病理特征、诊断与鉴别诊断、治疗和预后进行回顾性分析并进行文献复习。结果:2例GIST肝转移病例中,1例原发灶来自小肠,13年后发生肝转移,术后给予甲磺酸伊马替尼(格列卫)400mg/d治疗,1个半月后因出现严重不良反应而放弃。1年10个月后再次复发,出现肝脏、肾脏、腹膜及膈肌广泛转移,术后再次给予甲磺酸伊马替尼治疗,并坚持服用至今达8个月。另1例原发于大网膜,原发肿瘤切除后2.5年发生肝转移,术后给予甲磺酸伊马替尼400mg/d治疗,坚持服用至今达15个月。2例自发生肝转移随访至今分别为2.5年和1.5年,无再次复发和转移,均存活。结论:胃肠道间质瘤发生肝转移或再发转移经手术切除病灶,再给予格列卫,可延长生存期,获得较好疗效。Background and purpose： Literature report of treatment and prognosis in gastrointestinal stromal tumors（GIST） with hepatic metastasis and recur rent metastasis was rare, This study was to discuss the clinicopathological characteristics and the situation of treatment and prognosis in GIST with hepatic metastasis and recurrent again metastasis. Methods： We reviewed two cases of GIST with hepatic metastasis reported from our hospital, and comprehensively analysed the related literature. Results： Two cases of GIST with hepatic metastasis in our hospital were analysed： one case of primary intestinel tumor,13 years after the treatment of the patient was diagnosed with hepatic metastasis. After operation, the patient accepts imatinib mesylate therapy for 400 mg per day and gave up one and a half month later because of serious side reactions. 1 year 10 months later, the patient was diagnosed with liver, kidney, peritoneum and diaphragm metastasis again, after excised lesions the patient continued to accept Imatinib therapy, and persisted takes about 8 months until now. The primary tumor of recowd case came from greater omentum, 2.5 years later after primary tumor excised hepatic metastasis occured, after operation the patient accepted Imatinib therapy for 400 mg per day, until now 15 months. Two cases followed respectively until now was 2.5 and 1.5 years, without recurrence or metastasis again, all are surviving. Conclusions： The patients of GIST with hepatic metastasis and recurrence again, by suitably lengthened Imatinib therapy cycle after the excision of the lesions, it is still to be possible to obtain the good curative effect.

关 键 词：胃肠道间质瘤 肿瘤转移 化疗 预后 

分 类 号：R730.262[医药卫生—肿瘤]