小肠间质瘤26例诊治分析  

Analysis of diagnosis and treatment of the small intestinal stromal tumors(26 cases)

作　　者：张德巍[1] 董彪[1] 

机构地区：[1]中国医科大学附属第四医院第三普通外科,辽宁沈阳110032

出　　处：《中国现代普通外科进展》2015年第8期605-608,631,共5页Chinese Journal of Current Advances in General Surgery

基　　金：辽宁省自然基金资助项目(20102260)

摘　　要：目的：探讨小肠间质瘤（SIST）的临床特点、辅助检查、诊断及治疗方法.方法：回顾性分析2008年1月-2014年1 0月收治的26例SIST患者的临床表现、辅助检查结果、治疗方法、病理检查及预后.结果：SIST常表现为消化道出血,腹部包块,腹部不适、隐痛,急性肠梗阻,发病部位多见于空肠、回肠、十二指肠,CT、小肠镜、胶囊内镜、肠系膜血管造影有较高的诊断率.26例SIST患者中,外生型肿瘤19例、腔内生长型3例、混合生长型4例;肿瘤直径0.5 ～23 cm;单发24例,多发2例;梭形细胞21例,上皮样细胞3例,混合细胞型2例;Miettinen-Lasota SIST危险度评估极低度危险性2例,低度危险性6例,中度危险性13例,高度危险性5例;免疫组化CD117、DOG-1、CD34、S-100、SMA、Ki-67、Desmin表达阳性率分别为92.30％、100％、73.08％、23.08％、34.62％、80.77％、15.38％.结论：SIST临床表现多样化,早期诊断困难,治疗以手术为主,中、高度危险性的SIST选用靶向治疗能取得良好的疗效.Objective：To discuss the clinical characteristics,auxiliary examination、diagnosis and treatment of the small intestinal stromal tumors （SIST）.Methods：Retrospective analysis clinical characteristics、auxiliary examination、treatment、pathological、immunohistochemical and prognosis of 26 cases small intestinal stromal tumors between Jan 2008 and Oct 2014 in our hospital.Re· sults：The SIST always performent gastrointestinal bleeding、abdomen mass、abdomen discomfort、dull pain、acute intestinal obstruction;Lesions parts：jejunum 16 cases,ileum 7 cases,duodenum 3 cases;The sensibility and specificity of the auxiliary examination show differences between different clinical manifestation of the SISTS.CT、enteroscope、capsule endoscopy and mesenteric angiography show highly diagnostic rate.Study object have exophytic tumor 19 cases、cavity growth form 3 cases and mix growth form 4 cases;tumor sizes 0.5-23cm;single tumor 24 cases、multiple tumor 2 cases、pindle cell 21 cases、epithelioid cell 3 cases、mixed cellularity 2 cases.Risk assessment by Miettinen-Lasota SlST show very low risk 2 cases、low risk 6 cases、moderate risk 13 cases and highly risk 5 cases.Expression positive rate of immunohistochemical of the CD117、DOG-1 、CD34 、S-100、SMA、Ki-67 and Desmin are respectively 92.30％、100％、73.08％、23.08％、34.62％、80.77％and 15.38％.Conclusions：Diversified clinical characteristics and difficult early diagnosis of SIST.We choose different auxiliary examination to clinical manifestation;preferential surgical operation;It is also good for moderate and highly risk of the SIST treated by targeted therapy.

关 键 词：小肠间质瘤 诊断 治疗 

分 类 号：R735.3[医药卫生—肿瘤]