论文部分内容阅读
目的:探讨胃肠道间质瘤(GIST)的临床特点、治疗方法,以提高诊断和治疗效果。方法:回顾分析2001年12月—2009年12月31例胃肠道间质瘤患者的临床诊断、治疗、病理资料及随访。结果:GIST好发于胃和小肠,临床表现缺少特异性,16例(51.6%)GIST发生于胃,8例(25.8%)发生于小肠,3例(9.7%)发生于结直肠(其中2例伴有肝转移),发生于肠系膜、网膜及腹膜后4例(12.9%)。CT检查呈现不规则软组织肿块,大部分边界完整。GIST表达CD117阳性者28例(90.3%),CT34阳性者22例(71.0%)。18例恶性GIST中9例接受甲磺酸伊马替尼治疗,术后3年存活5例,9例未接受甲磺酸伊马替尼治疗者1例失访,术后3年存活0例。结论:在区别GIST与平滑肌瘤或神经源性肿瘤时,CD117、CD34具有重要价值。CT、内镜超声检查是目前诊断GIST常用和重要的手段,手术切除是首选的治疗方法,甲磺酸伊马替尼辅助治疗能够提高患者的生存期。
Objective: To investigate the clinical features and treatment of gastrointestinal stromal tumors (GIST) in order to improve the diagnostic and therapeutic effects. Methods: The clinical diagnosis, treatment, pathological data and follow-up of 31 patients with gastrointestinal stromal tumors from December 2001 to December 2009 were retrospectively analyzed. Results: GIST developed in the stomach and small intestine. The clinical manifestations were nonspecific. 16 (51.6%) GIST occurred in the stomach, 8 (25.8%) occurred in the small intestine and 3 (9.7%) occurred in the colorectum Cases accompanied by liver metastasis), occurred in the mesentery, omentum and retroperitoneum in 4 cases (12.9%). CT showed irregular soft tissue mass, most of the border integrity. Twenty-eight patients (90.3%) had CD117 positive expression in GIST and 22 (71.0%) patients had positive CT34 expression. Among 18 malignant GISTs, 9 were treated with imatinib mesylate, 5 survived 3 years after surgery, 9 were not treated with imatinib mesylate, and 0 survived 3 years after surgery . Conclusion: CD117 and CD34 are of great value in distinguishing GIST from leiomyoma or neurogenic tumor. CT, endoscopic ultrasonography is currently used to diagnose GIST common and important means of surgical resection is the preferred treatment, adjuvant imatinib mesylate treatment can improve the patient’s survival.