胃肠道间质瘤67例临床特征与预后分析  

Clinical Character and Prognosis of 67 Cases with Gastrointestinal Stromal Tumors

作　　者：姜铀[1] 耿艳丽[1] 刘岩[2] 孟艳[1] 孔露[3] 李东宁[3] 李骢[3] 

机构地区：[1]大连医科大学附属第二医院消化科,辽宁大连116023 [2]大连医科大学附属第二医院胃肠外科,辽宁大连116023 [3]大连医科大学病理生理学教研室,辽宁大连116044

出　　处：《医学与哲学（B）》2015年第10期45-48,共4页Medicine & Philosophy(B)

摘　　要：分析胃肠道间质瘤（GIST）的临床特点及预后情况，以提高临床医生对该疾病早期的诊断和治疗水平。回顾性分析2003年12月～2010年12月大连医科大学附属第二医院手术切除的67例GIST患者的临床资料。本组GIST患者发病年龄15岁～72岁，中位发病年龄59岁。GIST多发生于胃肠道内，本研究中胃占35例（52．24％），其次是小肠13例（19．40％）。67例患者中，最常见的临床表现为腹部不适（如腹痛、腹胀），占33．80％（22／67）；其次为消化道出血（如呕血、黑便），占28．17％（19／67）；镜下肿瘤细胞形态梭形细胞为主型45例，上皮样细胞为主型4侧，其他细胞形态18例；免疫组化CD117阳性率95．52％（64／67）、cD34阳性率74．63％（50／67）、SMA阳性率14．93％（10／67）、S-100阳性率8．96％（6／67）、Ki-67阳性率67．16%（45／67）。67例患者随访3个月～48个月，失访10例，肿瘤复发15例，其他死亡原因者6例，余36例患者一般情况良好。GIST发病多见于50岁以上，确诊需病理及免疫组化结果。手术是GIST最主要和最有效的治疗方法，对不能手术切除的或出现复发转移的建议行分子靶向治疗。To investigate the clinical features and prognosis of gastrointestinal stromal tumor for early clinical diagnosis and treatment. A total of 67 patients with GISTs in the Second Affiliated Hospital of Dalian Medical University were involved in the retrospectively study from December 2003 to December 2010. There were 35 males and 32 females with age of 15- 72 years old and 59 years old on average. It occurs most often in the stomach GIST group was 52. 24%（35/67）, followed by the small intestine accounted Was 19.4 % （13/67）. the most common symptoms were abdominal discomfort （abdominal pain,bloating） in 22 patients （33. 8%）, followed by gastrointestinal bleeding （vomiting or melena） in 19 patients （28.17%）. Spindle cell were 45cases, epithelial-like cells were 4cases, other type were 18cases. Immunohistochemical staining showed the positive rate of the CDllT,CD34,SMA, S-100, Ki-67 were 95. 52%,74. 63%,14. 93%,89. 6%, 67.16%respectively. 10 cases failed to follow-up, death in 6 patients, recurrence in 15 cases, the others had not been found recurrence. Immunohistoehemistry and pathological detection is helpful to the definitely diagnosis of GIST. Operation is the most effective treatment for GIST, molecular targeted therapies are redommended to those patients with metastasis and recurrence.

关 键 词：胃肠道间质瘤 临床特征 预后 

分 类 号：R735.3[医药卫生—肿瘤]