胃肠道及胃肠道外间质瘤216例临床病理学特点分析  

Clinicopathologic features of gastrointestinal stromal tumors and extragastrointestinal stromal tumors:an analysis of 216 cases

作　　者：沈旺[1] 王新允[2] 郑海燕[3] 武力[2] 袁海洪[2] 

机构地区：[1]天津医科大学临床七年制学生,天津300070 [2]天津医科大学总医院,天津300052 [3]天津医科大学第二医院,天津300211

出　　处：《中国实用外科杂志》2011年第8期693-695,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨胃肠道间质瘤(gastrointestinal stromaltumor,GIST)和胃肠道外间质瘤(extragastrointestinal stromaltumor,EGIST)的临床病理和免疫组化特点及其诊断标准。方法回顾性分析天津医科大学总医院及第二医院2000—2009年已确诊的216例GIST和EGIST病人的临床资料,其中,天津医科大学总医院175例,天津医科大学第二医院41例。结果 216例病人中,男性112例,女性104例,男女比例为1.077:1;发病年龄15～91岁,中位年龄58岁;肿瘤原发于胃肠道者182例,以胃多见;胃肠道外者34例,以肠系膜多见。肿瘤直径0.8～30.0cm,由梭形细胞和上皮样细胞组成,细胞排列呈交叉束状、漩涡状及巢状。214例CD117呈阳性。临床多表现为消化道出血、腹部疼痛、腹部肿块及肠梗阻等症状。结论 GIST较EGIST多见;胃肠道以中、高度危险者多见,胃肠道外以高度危险者多见。临床治疗原则首选广泛手术切除。Objective To investigate the features of clinicopathotogy and immunohistochemistry and the diagnostic criteria of gastrointestinal stromal tumor （G1ST）and extragastrointestinal stromal tumor （EGIST）. Methods The case data of 216 patients diagnosed as GIST and EGIST admitted between 2000 and 2009 in Tianjiu Medical University General Hospital （175 patients） and the Second Hospital （41 patients）were analyzed retrospectively. Results In the 216 patients, 112 patients were male and 104 patients were female. The ratio of male to female was 1.077：1. The range in age was from 15 to 91 years old. The median age was 58 years old. The tumors originated from the gastrointestinal tract were in 182 patients, and most of them were located in the stomach. The tumors originated from the extragastrointestinal tract were in 34 patients, and most of them were located in the mesenterium. The range in the diameter of tumors was from 0.Scm to 30.0cm. Tumors were composed of spindle cells and epithelioid cells. Cells arranged in interlacing, whorled and nesting. CD117-test was positive in 214 cases. Clinical manifestations were alimentary tract hemorrhage, abdominal pain, abdominal mass, intestinal obstruction and so on. Conclusion GISTs are more than EGISTs. Medium risk and high risk are predominant in the gastrointestinal tract, and high risk is predominant in the extragastrointestinal tract. Wide excision is the first choice in the clinical treatment principle.

关 键 词：胃肠道间质瘤 胃肠道外间质瘤 临床病理学特点 

分 类 号：R6[医药卫生—外科学]