胃肠外间质瘤的诊断和治疗(附15例报告)  

The Diagnoses and Treatment of Extragastrointestinal Stromal Tumors:A Report of 15 Cases

作　　者：江晓晖[1] 蒋松琪[1] 谢鹏飞[1] 陈志刚[1] 陈铁[1] 

机构地区：[1]南通大学附属肿瘤医院外科,江苏南通226361

出　　处：《肿瘤基础与临床》2009年第3期237-238,共2页journal of basic and clinical oncology

摘　　要：目的探讨胃肠外间质瘤(EGIST)的临床病理特点、诊断及治疗。方法1998年1月至2006年12月收治的15例EGIST的临床、病理资料及治疗进行回顾性分析。结果15例均经手术及病理确诊,肿瘤位于肠系膜8例,大网膜5例,后腹膜2例。肿瘤平均直径为13.1cm,免疫组化CD117、CD34及α-SMA阳性率分别为100.0%、53.3%及33.3%,其临床表现无特异性,术前诊断主要依靠影像学检查,但定性诊断困难。本组均经手术治疗,9例完整切除,5例姑息切除,1例仅行活检术;联合脏器切除6例。经随访20～128个月,5例死于肿瘤复发和肝转移,3例带瘤生存,其余7例均存活且无复发。结论EGIST临床少见,生物学行为多变,预后和部位有关,位于大网膜者预后较好。手术是唯一能治愈的方法,格列卫可能有预防复发的作用。Objective To discuss the clinicaopathological characteristics, diagnoses and treatment of extragastrointestinal stromal tumors （ EGIST）. Methods The clinical and pathological data and treatment of 15 cases from January 1998 to December 2006 were analyzed retro- spectively. Results EGIST was diagnosed by surgery and pathology in all the cases, 8 cases arose from mesentery, 5 cases from greater omentum and 2 cases from retroperitoneum. The average size of tumors was 13.1 cm, immunohistochemical analysis display positive reactivity for CD117 （100, 0% ）, CD34 （53.3 % ） and α-SMA （33.3%）. There was no specificity on clinical presentations, imaging detections＇were the main diagnostic methods preoperatively, but qualitation of tumors was difficult. All the cases underwent surgical treatment, of all 9 cases were resected completely, 5 cases were resected palliatively, biopsy was performed in 1 case and combined organ resection was performed in 6 cases. During 20 to 128 months of follow-up, 5 cases died of tumor recurrence or liver metastasis,3 cases survived with tumors and the rest 7 cases survived without recurrence. Conclusion EGIST has a low prevalence clinically, the biological behaviour is changeable, the progno- sis related to tumor location, the tumors originated from greater omentnm have better prognosis. Surgical resection is the only curable method, and gleevec perhaps has the effect to prevent tumor recurrence.

关 键 词：胃肠外间质瘤 免疫组化 诊断 外科手术 

分 类 号：R735.2[医药卫生—肿瘤]