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目的总结恶性胃肠道间质瘤的(MGIST)的临床特点及治疗方法。方法回顾性分析1994年3月至2005年3月收治的60例MGIST患者的临床资料。结果60例患者中22例为潜在MGIST,38例为MGIST。病理检查,潜在MGIST患者肿瘤直径3．2～7．2(平均5．3)cm,瘤组织切面呈灰白、灰黄色,实性或有出血囊性变；MGIST患者肿瘤直径3．0～25．0(平均9．2)cm,瘤组织呈鱼肉样,肿瘤细胞丰富,可见不同程度出血坏死,明显异型性,核分裂多见。免疫组化测定：54例CD117阳性,53例CD34阳性,48例波形蛋白(vimentin)阳性,27例S100阳性,16例SMA阳性。全组患者均行手术完整切除肿瘤,2003年7月后有19例患者术后给予伊马替尼辅助治疗。41例单纯手术的患者术后2年内有80．5%的患者出现转移复发,而手术加伊马替尼辅助治疗者仅有21．1%的转移复发率(P＜0．05)。结论CD117和CD34标记阳性是诊断MGIST最有价值的血清学指标；确诊靠肿瘤病理切片。手术加伊马替尼辅助治疗有效。
Objective To summarize the clinical features and treatment of malignant gastrointestinal stromal tumors (MGIST). Methods The clinical data of 60 patients with MGIST admitted from March 1994 to March 2005 were retrospectively analyzed. Results Of 60 patients, 22 were potential MGIST and 38 were MGIST. Pathological examination showed that the diameter of tumor in patients with MGIST was 3.2 to 7.2 (average 5.3) cm. The surface of the tumor was gray, grayish yellow, solid or with hemorrhagic cystic degeneration. The diameter of MGIST patients was 3.0-25 .0 (average 9.2) cm, tumor tissue was fish-like, rich tumor cells, showing varying degrees of hemorrhage and necrosis, atypia, mitotic common. Immunohistochemical assay: 54 cases of CD117 positive, 53 cases of CD34 positive, 48 cases of vimentin positive, 27 cases of S100 positive, 16 cases of SMA positive. All patients underwent complete resection of the tumor. After July 2003, 19 patients were given imatinib adjuvant therapy. In 41 cases of simple operation, 80.5% of the patients had metastasis and recurrence within 2 years after operation, and only 21.1% of those with imatinib adjuvant had recurrence and metastasis (P <0.05). Conclusion The positive of CD117 and CD34 markers are the most valuable serological markers for the diagnosis of MGIST. The diagnosis is based on the tumor pathological sections. Surgery plus imatinib adjuvant therapy effective.