胃肠道间质瘤肝转移的诊断和治疗  

Diagnosis and treatment of hepatic metastasis from gastrointestinal stromal tumor

作　　者：沈英皓[1] 樊嘉[1] 吴志全[1] 周俭[1] 邱双健[1] 候英勇[2] 余耀[1] 黄晓武[1] 

机构地区：[1]上海复旦大学附属中山医院、复旦大学肝癌研究所,200032 [2]上海复旦大学附属中山医院病理科,200032

出　　处：《中华消化外科杂志》2008年第6期450-451,共2页Chinese Journal of Digestive Surgery

摘　　要：目的探讨胃肠道间质瘤（gastrointestinal stromal tumor，GIST）肝转移的诊断和治疗。方法回顾性分析1993年12月至2007年5月收治的16例GIST肝转移患者的临床资料。结果14例行根治性切除术，2例行姑息性切除术。3例根治性切除术及2例姑息性切除术患者术后服用伊马替尼治疗。术后随访时间3～161个月，14例根治性切除患者中共8例复发、转移。其中7例肝转移，3例采用肝动脉栓塞治疗，1例服用伊马替尼，2例手术切除，1例未治疗；1例腹壁转移，行手术切除。本组16例患者1、3年生存率分别为92％和74％。结论GIST肝转移术后复发率高，手术治疗GIST肝转移及术后复发、转移效果较好，联合服用伊马替尼可进一步提高患者生存率。Objective To investigate the diagnosis and treatment of hepatic metastasis from gastrointestinal stromal tumor （GIST）. Methods The clinical data of 16 patients with GIST who had been admitted to our hospital from December 1993 to May 2007 were retrospectively analyzed. Results Of all patients, 14 underwent radical resection and 2 underwent palliative operation. Two patients with palliative operation and 3 with radical resection were administered with imatinib postoperatively. All patients were followed up for 3-161 months, and GIST metastasis and invasion was observed in 8 of the 14 patients who received radical resection. Of the 7 patients with hepatic metastasis, 3 were treated with hepatic artery chemoembolization, 1 was administered with imatinih, 2 received reoperation and 1 did not receive any treatment. Reoperation was carried out on 1 patient who had abdominal wall metastasis. The 1- and 3-year survival rates of the 16 patients were 92% and 74% , respectively. Conclusions The recurrence rate of GIST after hepatectomy is high. Complete surgical resection is the best curative treatment for hepatic metastasis from GIST and GIST recurrence. The combination of surgical resection and imatinih administration may help to improve the prognosis of patients with hepatic metastasis from GIST.

关 键 词：胃肠道间质肿瘤 肿瘤转移 治疗 

分 类 号：R735[医药卫生—肿瘤]