肠道来源的胃肠道间质瘤83例临床分析  

Clinical features of 83 cases of intestinal stromal tumors

作　　者：张博淼[1] 王锡山[1] 迟强[1] 李大川[1] 王宏志[1] 

机构地区：[1]哈尔滨医科大学附属第二医院普通外科,黑龙江哈尔滨150086

出　　处：《胃肠病学和肝病学杂志》2015年第5期575-578,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨发生在肠道的胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的临床及病理特点,分析生存率及预后相关因素。方法回顾分析83例经手术治疗的肠道来源的GIST患者的临床及病理资料,对部分病例进行免疫组化检测,标记抗体为CD117、CD34、Vimentin和S100,并通过随访部分病例分析影响患者生存率和预后的相关因素。结果 83例肠道来源的GIST患者中,病灶起源于小肠及其系膜的患者主要以腹部不适及疼痛(20.48%)或腹部包块(22.89%)为主要症状;病灶起源于结直肠的患者主要以便血(32.53%)及排便习惯改变(12.05%)为主要症状。患者CD117、CD34、Vimentin、S100蛋白的表达分别为94.34%、81.13%、80.95%和38.10%。发病部位、术式、术中输血量等都与患者的生存率和预后密切相关(P<0.05)。结论肠道来源的GIST的临床表现与发病部位相关,CD117、CD34、Vimentin、S100蛋白的表达比较高,有助于对该病的诊断,患者的生存率和预后与发病部位、术式、术中输血量等因素相关。Objective To investigate the clinical and pathological features of intestinal stromal tumors, and analyze the related factors of survival rate and the prognosis. Methods Eighty-three cases of intestinal stromal tumors were ret- rospectively studied. Among them, part cases were immunostained by antibodies against CDl17, CD34, Vimentin and S100, the related factors influencing the survival rate and prognosis were analyzed by follow-up. Results In eighty- three cases of intestinal stromal tumors, patients with tumor located in small intestine and mesenterium appeared the main symptoms of abdominal pain （20.48%） and abdominal mass （22.89%） , patients with tumor located in colorec- rum appeared the main symptoms of hematochezia （32.53%） and changes in bowel habits （12.05%）. Immunopheno- typically, percentages of positivity for the 4 antibodies were as follows： CD117 （94.34%）, CD34 （81.13%）, Vimen- tin （80.95%） , S100 （38.10%）. Site, surgical method and blood transfusion volume were related to survival rate and prognosis （P 〈 0.05）. Conclusion Clinical manifestation of patients with intestinal stromal tumors was related to site ; CD117, CD34, Vimentin and S100 were meaningful to the diagnosis of this disease. Site, surgical method and blood transfusion volume can influence patients＇ survival rate and prognosis.

关 键 词：胃肠道间质瘤 免疫组织化学 临床表现 生存率 预后 

分 类 号：R735[医药卫生—肿瘤]