胃间质瘤并发腺癌的临床病理特征及影像表现  

Clinicopathological features and imaging findings of synchronous gastric stromal tumors and adenocarcinoma

作　　者：史曙光 袁刚 王江涛 周莹 SHI Shuguang;YUAN Gang;WANG Jiangtao;ZHOU Ying(Department of Radiology,Affiliated Lianyungang Hospital of Xuzhou Medical University,First People’s Hospital of Lianyungang,Lianyungang 222002,P.R.China;Department of Medical Center,Affiliated Lianyungang Hospital of Xuzhou Medical University,First People’s Hospital of Lianyungang,Lianyungang 222002,P.R.China)

机构地区：[1]徐州医科大学附属连云港医院连云港市第一人民医院放射科,江苏连云港222002 [2]徐州医科大学附属连云港医院连云港市第一人民医院体检中心,江苏连云港222002

出　　处：《医学影像学杂志》2020年第2期246-250,共5页Journal of Medical Imaging

摘　　要：目的探讨胃间质瘤并发腺癌的临床病理特征及影像学表现。方法回顾性分析6例经手术切除的胃间质瘤并发腺癌的临床病理资料及MSCT表现特点。结果6例胃间质瘤并发腺癌均经病理证实为原发肿瘤,免疫组化示CD34及CD117阳性。间质瘤低危3例,极低危3例。间质瘤的平均大小为(1.73±1.37)cm。间质瘤腔内型3例,腔外型3例。平扫病灶呈等密度,动脉期、门静脉期间质瘤病灶呈渐进性强化。并发胃腺癌的平均大小为(2.73±0.76)cm,所有胃腺癌病例均见黏膜中断、溃疡形成;2例浆膜受累及,3例伴胃周淋巴结肿大。结论胃间质瘤并发腺癌多数为偶然发现,诊断主要依靠病理,特别是免疫组化。术前影像检查易漏诊,胃粘膜异常改变具有一定提示价值。Objective To investigate the clinicopathological features and imaging findings of gastric stromal tumors complicated with adenocarcinoma.Methods The clinicopathological data and MSCT features of 6 cases of gastric stromal tumors complicated with adenocarcinoma were retrospectively analyzed.Results Six cases of gastric stromal tumors complicated with adenocarcinoma were pathologically proved to be primary tumors.Immunohistochemical staining showed that CD34 and CD117 were positive.The risk of stromal tumors was low in 3 cases and very low in another 3 cases.The average size of stromal tumors was(1.73±1.37)cm.There were 3 cases of intracavitary type and 3 cases of extraluminal type of stromal tumor.The lesions showed isodensity in plain scan,and progressive enhancement in arterial phase and portal phase in stromal tumors.The mean size of gastric adenocarcinoma was(2.73±0.76)cm.Mucosal disruption and ulceration were found in all cases,and serosal involvement was found in 2 cases.There were 3 cases with perigastric lymphadenopathy.Conclusion Gastric stromal tumors complicated with adenocarcinoma are mostly found by accident,and their diagnosis depends on pathology,especially immunohistochemistry.Preoperative imaging is easy to miss diagnosis,and gastric mucosal abnormal changes have certain value.

关 键 词：胃肠道腺癌 胃肠道间质瘤 同时发生 体层摄影术 X线计算机 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]