直肠间质瘤16例临床诊治分析  

Gastrointestinal stromal tumor of the rectum: an analysis of 16 cases

作　　者：吴斌[1] 邱辉忠[1] 肖毅[1] 林国乐[1] 周皎琳[1] 张双民[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院基本外科,北京100730

出　　处：《中国肿瘤临床与康复》2009年第4期367-368,371,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨直肠间质瘤的外科诊断与治疗特点。方法对2003年以来的16例直肠间质瘤患者的临床资料进行回顾性分析。结果本组男11例，女5例，发病年龄27～81岁。9例患者无症状，7例有症状者表现为便血4例，排便困难2例，便形改变2例，肛周疼痛1例。经肛门括约肌途径直肠肿物切除（Mason术）7例，经肛门肿物切除术5例，腹会阴联合切除（Miles术）3例，经肛门内镜显微手术（TEM）1例。肿瘤直径最小0．4cm，最大者18．5cm，其中小于2cm6例，2．1～5cm7例，5．1～10cm2例，大于10cm1例。免疫组化结果CD117阳性15例，CD34阳性12例，Desmin阳性2例，SMA阳性4例。2例患者出现术后复发及远处转移，口服伊马替尼治疗有效。结论直肠间质瘤的治疗以手术为主，伊马替尼对复发转移的间质瘤患者有效。Objective To investigate the clinicopathologic characteristics of rectal GISTs. Methods The medical records of 16 patients who underwent surgery for GIST of the rectum were analyzed. Results There were 11 men and 5 women with a median age of 48 years （range, 27-81 years） at the time of diagnosis. All patients underwent curative resection： in the form of abdominoperineal resection in 3 patients, transanal excision in 5, Mason＇s operation in 7, and transanal endoscopic microsurgery in one. The median tumor size was 3. 7 cm （range, 0. 4 cm-18 cm）. Fifteen of 16（93. 8% ） were positive for CDll7, 12 （75.0%） positive for CD34, 4 positive for SMA, 2 positive for Desmin. Local recurrence and hepatic metastasis developed in two patients after operation, and were then treated effectively with imatinib for more than 1 year. Conclusions The primary treatment of rectal GIST is surgical. Imatinib therapy is effective against local and systemic recurrent GIST.

关 键 词：直肠肿瘤 间质瘤 诊断 治疗 

分 类 号：R735.37[医药卫生—肿瘤] R730.4[医药卫生—临床医学]