论文部分内容阅读
目的探讨胃肠道间质瘤(GIST)的诊断、临床病理特征、良恶性的判断和外科治疗。方法回顾性分析48例GIST的临床和病理资料。结果本组GIST位于胃27例,小肠14例,结肠5例,肛管2例。27例行胃镜检查,确诊4例,发现病灶21例,其中8例行超声胃镜并穿刺活检,6例确诊。CD117阳性率为89.6%(43/47),CD34阳性率为69.5%(33/47)。病理诊断良性间质瘤13例,交界性8例,恶性27例。本组均行肿瘤局部切除或局部消化道部分切除。48例随访6～60个月,13例良性间质瘤患者全部存活,27例恶性及8例交界性间质瘤患者中1例于术后8月复发,3例术后16月发生转移,8例术后36月死亡。结论超声内镜结合胃肠道影像学检查是临床诊断GIST的主要方法,确诊需依靠组织病理学检查和免疫组化染色,外科手术完整切除是原发GIST最主要的治疗方式。
Objective To investigate the diagnosis, clinicopathological features, benign and malignant judgment and surgical treatment of gastrointestinal stromal tumors (GIST). Methods Retrospective analysis of 48 cases of GIST clinical and pathological data. Results The group of GIST in the stomach 27 cases, 14 cases of small intestine, colon 5 cases, 2 cases of anal canal. Twenty-seven routine gastroscopy were diagnosed in 4 cases and 21 lesions were found. Among them, 8 cases underwent endoscopic ultrasonography and biopsy and 6 cases were diagnosed. The positive rate of CD117 was 89.6% (43/47) and the positive rate of CD34 was 69.5% (33/47). Pathological diagnosis of benign stromal tumors in 13 cases, 8 cases of borderline, malignant 27 cases. This group of patients underwent partial tumor resection or partial gastrointestinal resection. 48 patients were followed up for 6 to 60 months. Thirteen patients with benign stromal tumors survived. One of 27 patients with malignant and 8 borderline stromal tumors recurred after operation in August and three patients had metastasis at 16 months after operation. Eight patients died after 36 months. Conclusion Ultrasound endoscopy combined with gastrointestinal imaging is the main method of clinical diagnosis of GIST. The diagnosis depends on histopathological examination and immunohistochemical staining. Surgical resection is the most important treatment for primary GIST.