胃肠道间质瘤临床诊治分析

摘要

[ABSTRACT]Objective: To explore the clinical features,diagnosis and treatment of gastrointestinal stromal tumors(GIST).Methods:Clinical and pathological data of the 37 GIST cases treated in our hospital were reviewed retrospectively.Results:OF all the 37 cases,22 cases were located in the stomach,2 in the esophagus,9 in the small intestine,4 in the colorectum;16 cases with GIST presented with upper abdominal pain,9 cases with gastrointestinal bleeding,including 2 cases with the uncontrolled hemorrhagic shock,8 cases with intestinal obstruction,7 cases with abdominal mass;All the cases underwent radical surgery,one of the cases underwent palliative resection,others achieved complete excision with clear resection margins;There was no operation-related mortality and surgical complications.All of the case were followed up from 3 months to five years after operation.2 cases died of tumor recurrence and metastasis,3 cases of hepatic metastasis remain survived after further surgery in follow-up period.Conclusion:The GIST patients lack of specific clinical manifestations,The diagnosis is usually confirmed by pathological and immunohistochemistry examinations. Surgical treatment combined with molecular targeted therapy of individualized comprehensive treatment is the therapeutic method.%目的：探讨胃肠道间质瘤的临床特点、诊疗方法。方法：回顾性分析37例胃肠道间质瘤的临床病理资料。结果：本组胃间质瘤59.5%（22/37），十二指肠间质瘤5.4%（2/37），空回肠间质瘤24.3%（9/37），结直肠间质瘤10.8%（4/37）；临床表现缺乏特异性，其中腹痛、上腹部不适43.2%（16/37），消化道出血24.3%（9/37），其中失血性休克5.4%（2/37），肠梗阻21.6%（8/37），腹部肿块18.9%（7/37）；37例患者均实施外科手术，1例姑息切除，其余36例均完整切除肿瘤，无围手术期死亡，术后无严重手术并发症发生；37例患者术后随访3个月至5年，2例死亡，3例出现肝脏转移，经再次手术随访期内正常生存。结论：胃肠道间质瘤缺乏特异性的临床表现，诊断主要依靠病理组织学检查及免疫组化检测。治疗方法为手术治疗与分子靶向治疗结合的个性化综合治疗。