胃肠间质瘤35例诊治体会  

Gastrointestinal stromal tumors in 35 cases

作　　者：范西红[1] 张小化[1] 张小桥[1] 王晨龙[1] 孙力勇[1] 庄大勇[1] 孙英刚[1] 

机构地区：[1]济南军区总医院普外科,山东济南250031

出　　处：《中华肿瘤防治杂志》2009年第9期713-714,共2页Chinese Journal of Cancer Prevention and Treatment

摘　　要：为了探讨胃肠间质瘤（GIST）的诊断和治疗，回顾性分析35例GIST的临床资料及预后。病变位于胃21例，小肠7例，直肠3例，十二指肠和小肠系膜各2例。临床主要表现为腹部疼痛不适、腹部包块及消化道出血。B超、CT检查示，腹腔肿瘤18例中，胃占位病变11例，直肠占位和盆腔肿瘤各2例，肝占位或转移8例。16例内镜检查示，胃黏膜下病变11例，直肠黏膜下病变1例；7例行超声内镜检查，5例提示胃间质瘤，1例提示直肠间质瘤。术前14例初诊为胃间质瘤，仅1例病理确诊。35例均行手术切除，其中姑息性切除9例，根治性手术26例，无手术死亡。33例患者获得随访3～128个月，中位随访时间27个月。全组死亡11例（33．3％），生存时间6～59个月，中位生存时间13个月；22例生存（66．7％），生存时间3～128个月，中位生存时间28个月。4例患者术后格列卫辅助治疗，仅1例带瘤生存。初步研究结果提示，GIST临床无特征性表现，超声内镜有助诊断，只有彻底切除肿瘤有望取得好的疗效，正规使用格列卫有助提高疗效。The objective of this study was to explore the diagnosis and treatment methods for gastrointestinal stromal tumors （GIST）. The clinical data of 35 cases of GISTs were retrospectively analyzed. The lesion was in the stomach in 21 cases, in the intestine in 7 cases, in the rectal in 3 cases, in the duodenal in 2 cases, and in the mesentery of small intestine in 2 cases. The clinical symptoms were abdominal pain, abdominal mass, and gastrointestinal bleeding. By B-ultrosound or CT examinations, 18 cases were abdominal tumors, 11 cases were gastric occupying le sions, 2 cases were rectal occupying lesions, 2 cases were pelvic tumors, and 8 cases were hepatic occupying lesions or metastasis lesions. By endoscopy, 11 of 16 cases were gastric mucosal lesions and 1 of 16 cases was rectal mucosal lesion. Only 1 of 14 cases primarily diagnosed GISTs was proved as GIST by pathological examination. Nine of the 35 cases were subjected to palliative resection and 26 radical resection. No patient died during the operation. Thirty-hree cases were followed up from 3 to 128 months, of them 11 cases （33.3%） died within 6 to 59 months and 22 cases （66.7%） survived. Four cases were also treated by imatinib mesylate, only 1 of them survived with tumor. In conclusion, GIST has no specific symptoms. Endoscopy is helpful in diagnosis. Complete resection and regular use of imatinib mesylate is good in improving efficacy.

关 键 词：胃肠间质瘤/诊断 胃肠间质瘤/外科学 伊马替尼/治疗应用 

分 类 号：R735[医药卫生—肿瘤]