十二指肠胃肠道间质瘤的外科治疗及预后分析  

Surgical therapy and prognostic analysis for duodenal gastrointestinal stromal tumor

作　　者：王昕海[1] 李孟军[1] 唐一帆[1] 吴双杰[1] 刘骏[1] 

机构地区：[1]复旦大学附属华山医院普外科,上海200040

出　　处：《外科理论与实践》2013年第6期552-555,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨十二指肠胃肠道间质瘤(gastrointesinal stromal tumor,GIST)的诊断、外科治疗和预后。方法:回顾性分析2006年3月至2012年10月收治11例十二指肠GIST病人的临床资料,并与同期治疗胃和小肠GIST病人的临床特征及预后进行比较。结果:11例病人CT的检出率为100%,内镜病理检出率为25%。均行手术切除治疗。2例行胰十二指肠切除术,7例行肿瘤局部切除术,2例行十二指肠节段切除术;围手术期无病人死亡,2例分别于术后10个月和2年出现复发、转移。十二指肠GIST病人的1年和2年无复发生存率为91%(10/11)和82%(9/11),预后略差于胃和小肠GIST。结论:十二指肠GIST的术前诊断应综合应用内镜和影像学技术,以提高其确诊率。治疗首选手术切除,根据肿瘤位置和大小合理选择手术方法。低危病人手术后基本可以治愈,中、高危病人术后应配合伊马替尼辅助治疗。该病的预后略逊于胃和小肠GIST。Objective To discuss the diagnosis, surgical therapy and prognosis of duodenal gastrointestinal stromal tumor （GIST）. Methods We retrospectively analyzed clinical data of 11 cases of duodenal GIST treated in our hospital between Mar 2006 and Oct 2012. Those with gastric and small intestinal GIST treated in the same period were compared in clinical characteristics and prognosis. Results The detection rate of CT scan for all the 11 cases was 100%, and accu- racy of endoscopic biopsy was 25%. All patients received surgical therapy including 2 cases pancreaticoduodenectomy, 7 cases local resection and 2 cases segmental duodenectomy. None of them died during the perioperative period. Two pa- tients developed metastasis and recurrence 10 months and 2 years after surgery respectively. The 1 year and 2 year recur- rence free survival （RFS） rates of duodenal GIST were 91%（10/11） and 82%（9/11）, which were slightly worse than those of gastric and small intestinal GIST. Conclusions Combination of endoscopy and imaging techniques should be comprehen- sively used to improve the preoperative diagnosis of duodenal GIST. Surgical therapy is preferred for this disease. Optimal resection depends on tumor location and size. Low-risk patients can be cured after surgery, and mediate and high-risk pa- tients should have imatinib adjuvant therapy. The prognosis of duodenal GIST is slightly worse than that of gastric and small intestinal GIST.

关 键 词：十二指肠肿瘤 胃肠道间质瘤 手术治疗 预后 

分 类 号：R735.31[医药卫生—肿瘤]