消化道平滑肌肿瘤的诊断与治疗(附175例报告)  

The diagnosis and treatment of smooth muscle tumors of the alimentary tract:a report of 175 cases.

作　　者：彭俊生[1,2] 陈正煊[1,2] 詹文华[1,2] 王吉甫 黄美近[1,2] 林汉良[1,2] 周慕衍 

机构地区：[1]中山医科大学附属第一医院胃肠外科 [2]中山医科大学病理教研室

出　　处：《中国实用外科杂志》1999年第5期304-306,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨消化道平滑肌肿瘤（ＳＭＴ）的临床病理特点和外科处理问题。方法收集和分析１７５例消化道ＳＭＴ的临床病理资料。结果平滑肌瘤６８例，上皮样平滑肌瘤３例，平滑肌肉瘤１０４例；位于食管１６例，胃７９例，小肠４２例，直肠１８例，十二指肠和结肠均为１０例。主要临床表现为腹痛、消化道出血及腹部包块。内镜和Ｘ线钡剂检查联合应用的术前阳性诊断率达８６６％。手术切除率为９２６％。结论消化道ＳＭＴ好发于胃和小肠。肿瘤核分裂指数高的ＳＭＴ可能预后较差。手术和再次手术切除肿瘤值得提倡。Objective To investigate the clinicopathological behavior and the surgical management of smooth muscle tumors(SMT)of the alimentary tract.Methods The clinical course and pathologic features were analyzed for 175 patients with SMT.Results In the series,68 cases were leiomyomas,3 epithelioid leiomyomas,and 104 leiomyosarcomas.16 cases were in the esophagus,79 in the stomach,42 in the small bowel,18 in the rectum,10 in the duodenum and the colon each.The most common presenting symptoms and signs were abdominal pain,gastrointestinal bleeding,and abdominal mass.86 6% of the tumors were diagnosed preoperatively by combining gastrointestinal endoscopy and barium meal or enema examination.92 6% of the tumors were resectable.Conclusion SMT of the alimentary tract often occurred in the stomach and the small bowel.Mitotic index is an important criterion to distinguish the benign SMT from malignant.The higher the frequency of mitoses,the worse the prognosis may be.The management of SMT should be put emphasis on surgical operation and re-operation.

关 键 词：消化道肿瘤 平滑肌瘤 平滑肌肉瘤 SMT 

分 类 号：R735[医药卫生—肿瘤]