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目的探讨胃肠道间质瘤(GIST)的临床特征及诊治方法。方法选取GIST患者23例,回顾性分析患者的临床资料。结果 23例GIST发生部位:胃13例、小肠6例、结肠3例、肠系膜1例。患者表现为腹部不适9例、肠梗阻4例、消化道出血3例、腹部包块2例、进食哽噎感1例、无症状4例。术后免疫组织化学显示CD117阳性21例,DOG1阳性22例,CD34阳性19例,平滑肌肌动蛋白阳性3例,S-100阳性1例。23例患者均行手术治疗,其中切缘的肉眼及显微镜下阴性切除18例,切缘的肉眼阴性而显微镜下阳性切除3例,切缘的肉眼及显微镜下阳性切除2例;联合其他脏器切除5例。21例患者获0.5~5年随访,失访2例。获随访的21例中,死亡11例;后者分别于术后第6、8、9、17、20、38、41个月死亡各1例,术后第13、21个月死亡各2例。结论 GIST临床表现无特异性,主要依靠术后病理及免疫组织化学明确诊断。外科手术切除仍然是主要及有效的治疗方法。
Objective To investigate the clinical features and diagnosis and treatment of gastrointestinal stromal tumors (GIST). Methods Twenty-three patients with GIST were selected and their clinical data were retrospectively analyzed. Results Twenty-three cases of GIST occurred in 13 cases of stomach, 6 cases of small intestine, 3 cases of colon and 1 case of mesentery. Patients showed abdominal discomfort in 9 cases, intestinal obstruction in 4 cases, gastrointestinal bleeding in 3 cases, abdominal mass in 2 cases, eating rickets in 1 case, 4 cases were asymptomatic. Immunohistochemistry showed that CD117 positive in 21 cases, DOG1 positive in 22 cases, CD34 positive in 19 cases, smooth muscle actin positive in 3 cases, S-100 positive in 1 case. Twenty-three patients underwent surgical treatment. Among them, there were 18 cases underwent gross and negative microsurgical resection of the margins, 3 cases were negative on the cut edge and 3 cases were under the microscope, and 2 cases were removed under the naked eye and under the microscope. Excision of 5 cases. 21 patients were 0.5 to 5 years follow-up, lost 2 cases. Of the 21 patients who were followed up, 11 died. The latter died of one case each at the 6th, 8th, 9th, 17th, 20th, 38th, and 41th months after operation, . Conclusion The clinical manifestations of GIST are nonspecific and depend mainly on postoperative pathology and immunohistochemistry for definite diagnosis. Surgical resection remains the primary and effective treatment.