消化道颗粒细胞瘤临床特征分析  

Clinical features of gastrointestinal granular cell tumor:an analysis of 22 cases

作　　者：张晓静[1] 赵文君[1] 孟品 刘爱玲[1] 徐楠[2] 徐永红[1] ZHANG Xiaojing;ZHAO Wenjun;MENG Pin;LIU Ailing;XU Nan;XU Yonghong(Department of Gastroenterology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院消化内科,山东青岛266003 [2]大连医科大学附属第一医院麻醉科

出　　处：《青岛大学学报（医学版）》2024年第2期247-251,共5页Journal of Qingdao University(Medical Sciences)

基　　金：山东省自然科学基金青年科学基金项目(Z-R2020QH031)。

摘　　要：目的分析消化道颗粒细胞瘤(GCT)的临床特征,提高对消化道GCT的认识及其临床诊治水平。方法回顾性分析经病理确诊为消化道GCT病人22例的临床资料。结果22例病人中男17例,女5例,平均年龄(49.36±8.45)岁;发病部位为食管17例(77.27%),回盲部2例(9.09%),结肠3例(13.64%)。17例病人表现为非特异性消化道症状,内镜下病灶最大径0.29~2.00 cm。22例行CT检查,6例食管壁略增厚,1例盲肠壁略增厚,余15例未见明显异常。1例行PET-CT检查,食管下段轻度增厚,结节状代谢增高,SUVmax约2.1。22例行内镜检查,病灶黄色15例(68.18%),白色7例(31.82%)。13例行超声内镜(EUS)检查,病变起源于黏膜下层7例(53.84%),黏膜肌层5例(38.46%),固有肌层1例(7.70%);病变低回声12例(92.30%),低回声混有少量高回声改变1例(7.70%),回声均匀10例(76.92%),回声欠均匀3例(23.08%)。免疫组化检查显示,所有病灶均表达S100,部分表达CD68、SOX10、Ki-67、SDHB、CD34。20例行内镜下治疗,1例行手术治疗,1例随访。病人随访7~69个月,中位随访时间为23个月,除1例病人化疗后失访,余均未见肿瘤复发及转移。结论消化道GCT以男性为主,临床症状无特异性,内镜、EUS检查相结合可提高对其诊断率,确诊需依据病理学及免疫组化检查,内镜下治疗是安全有效的方法。Objective To investigatethe clinical features of gastrointestinal granular cell tumor(GCT),and to improve the understanding and clinical diagnosis and treatment of gastrointestinal GCT.Methods A retrospective analysis was performed for the clinical data of 22 patients with pathologically confirmed gastrointestinal GCT.Results Among the 22 patients,there were 17 male patients and 5 female patients,with a mean age of(49.36±8.45)years,and the lesion sites were the esophagus in 17 patients(77.27%),the ileocecusin 2 patients(9.09%),and the colon in 3 patients(13.64%).All patients presented with nonspecific gastrointestinal symptoms,and the maximum diameter of endoscopic lesions showed a range of 0.29-2.00 cm.All 22 patients underwent CT examination,among whom 6 had slight thickening of the wall of the esophagus and 1 had slight thickening of the wall of the cecum,and no obvious abnormality was observed for the other 15 patients.One patient underwent PET-CT,and the results showed mild thickening of the lower esophagus,with nodular metabolic hyperintensities and a SUVmax value of about 2.1.All 22 patients underwent endoscopic examination,among whom 15(68.18%)had yellow lesions and 7(31.82%)had white lesions.Endoscopic ultrasound(EUS)was performed for 13 patients,among whom 7(53.84%)had lesions originating from the submucosal la-yer,5(38.46%)had lesions originating from the muscularis mucosa,and 1(7.70%)had lesions originating from the muscularis propria;12 patients(92.30%)had hypoechoic lesions,and 1 patient(7.70%)had hypoechoic lesions mixed with a small amount of hyperechoic changes;10 patients(76.92%)had even echo,and 3(23.08%)had uneven echo.Immunohistochemistry showed the expression of S100 in all lesions and the expression of CD68,SOX10,Ki-67,SDHB,and CD34 in some lesions.Of all 22 patients,20 received endoscopic treatment,1 received surgical treatment,and 1 was followed up.The patients were followed up for 7-69 months,with a median follow-up time of 23 months;1 patient was lost to follow-up after chemotherapy,wh

关 键 词：颗粒细胞瘤 临床表现 腔内超声检查 病理状态 体征和症状 

分 类 号：R573.9[医药卫生—消化系统]