胃平滑肌肉瘤诊治分析36例  

Diagnosis and treatment of gastric leiomyosarcoma:an analysis of 36 cases

作　　者：韩文[1] 

机构地区：[1]成都市第五人民医院,四川省成都市611130

出　　处：《世界华人消化杂志》2008年第30期3448-3450,共3页World Chinese Journal of Digestology

摘　　要：目的:探讨胃平滑肌肉瘤的临床特征,总结其诊断和治疗经验,减少术前漏诊、误诊.方法:回顾性分析1980-01/2007-12我院36例胃平滑肌肉瘤临床及内镜资料,总结患者临床表现、诊断及治疗等临床特征.结果:36例患者中上消化道出血31例(86.1%),4例大出血导致休克.上腹包块22例(61.1%),无规律性上腹痛25例(69.4%),贫血28例(77.7%),幽门梗阻3例(9.6%).上消化道钡餐17例,诊断为胃癌10例,胃溃疡4例,3例未发现病灶.上腹部CT25例,18例胃实质性包块,其中诊断为胃平滑肌肉瘤5例,3例胰腺假性囊肿,4例胰头占位.31例作胃镜检查并取活检,仅7例确诊为胃平滑肌肉瘤(22.6%).肿瘤转移与肿瘤大小、生长方式及生长部位无关.结论:胃平滑肌肉瘤临床表现缺乏特征性,手术及病理检查是诊断和治疗的最佳方法.AIM： To investigate the clinical manifestations of gastric leiomyosarcoma as well as to summarize its diagnostic and therapeutic experience for decreased misdiagnosis and missed diagnosis. METHODS： Thirty-six cases of gastric leiomyosarcoma were retrospectively studied at our hospital from January 1980 through December 2007. Clinical manifestations, the diagnosis and treatment were investigated. RESULTS： Of 36 patients, 31 cases of upper gastrointestinal hemorrhage （86.1%）, 4 cases of shock caused by massive hemorrhage, 22 cases of epigastric masses （61.1%）, irregular epigastralgia （69.4%）, 28 cases of anemia （77.7%）, and 3 cases of pyloric obstruction （9.6%） were observed. Among 17 cases administrated with upper gastrointestinal barium meal, 10 was diagnosed as gastric carcinoma, 4 gastric ulcer and 3 no lesions. Among 25 upper gastrointestinal CT scans, 18 abdominal masses were found, of which, 5 cases were diagnosed as gastric leiomyosarcoma, 3 as pancreatic pseudocyst and 4 as pancreatic head cancer. Of 31 cases undergoing gastric endoscopy and biopsy, 7 cases were diagnosed as gastric leiomyosarcoma （22.6 %）. Tumor metastasis was not associated with tumor size, growth pattem or growth position. CONCLUSION： The clinical manifestations of gastric leiomyosarcoma were lack of specific features and gastric leiomyosarcoma is prone to misdiagnosis. Operation and histopathological examinations are best treatment and diagnostic options.

关 键 词：胃平滑肌肉瘤 内镜 诊断 

分 类 号：R735.2[医药卫生—肿瘤] R656.6[医药卫生—临床医学]