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目的探讨胃肠道间质瘤(GIST)的临床特点及诊治方法。方法对南京医科大学附属无锡市第二人民医院1998年1月至2008年3月间收治的56例胃肠道间质瘤病人进行回顾性分析。结果肿瘤最常见于胃部62.5%(35/56),其次为十二指肠5.4%(3/56)、空肠12.5%(7/56)、回肠17.9%(10/56)、结肠1.8%(1/56)。以恶性肿瘤多见,占67.9%(38/56),交界性19.6%(11/56),良性12.5%(7/56)。56例均获手术治疗。术后病理检查均无淋巴结转移。术后随访12个月至8年,48例获完整随访,1年、5年存活率分别为100%和78.57%。结论胃肠道间质瘤好发于胃,依次为小肠、结肠,以恶性者多见,其局部侵袭性不如消化道恶性肿瘤,淋巴结转移少见,术前诊断主要依据影像学检查、内镜及病理CD117和CD34阳性标记是确诊GIST有价值的免疫标记物;手术切除为主要治疗方法,其手术方式的选择多取决于肿瘤的部位和大小。
Objective To investigate the clinical features and diagnosis and treatment of gastrointestinal stromal tumors (GIST). Methods A retrospective analysis was performed on 56 cases of gastrointestinal stromal tumors admitted to the Second People’s Hospital of Wuxi City, Nanjing Medical University from January 1998 to March 2008. Results The most common tumors were 62.5% (35/56) in the stomach, followed by 5.4% (3/56) in the duodenum, 12.5% (7/56) in the jejunum, 17.9% (10/56) in the ileum, 1.8% (1/56). More common in malignant tumors, accounting for 67.9% (38/56), borderline 19.6% (11/56) and benign 12.5% (7/56). 56 cases were treated surgically. Postoperative pathological examination without lymph node metastasis. All cases were followed up for 12 months to 8 years. Forty-eight cases were followed up for 1 year and 5 years respectively. The survival rates were 100% and 78.57% respectively. Conclusions Gastrointestinal stromal tumors occur mainly in the stomach, followed by the small intestine and colon, which are more common in malignant patients. Their local invasiveness is not as good as that in gastrointestinal malignancies. Lymph node metastasis is rare. Preoperative diagnosis is mainly based on imaging examination, endoscopy and Pathology CD117 and CD34 positive markers is a valuable diagnostic marker of GIST immune marker; surgical resection as the main treatment, the choice of surgical approach depends on the location and size of the tumor.