胃肠道间质瘤30例外科诊治分析

摘要

Objective To explore the clinical characteristics,diagnosis and treatment of gastrointestinal stro-mal tumor( GIST) .Methods The clinical data of 30 patients with GIST who were admitted between June 2004 and June 2014 were analyzed retrospectively.Results In the 30 patients with GIST, the lesions were located in the stom-ach(14 cases), duodenum(2 cases), small intestine(10 cases), colon(2 cases) and rectum(2 cases).All the le-sions were identified by imaging examination.All patients underwent complete resections, including multiple organs resection(2 cases) and endoscopic resection(3 cases).After the operation, the diagnosis was confirmed by patholog-ical examination and immunohistochemistry.The results of immunohistochemistry demonstrated that tumor cells were positive for CD117 in 29 cases(96.7%), for CD34 in 22 cases(73.3%) and for DOG-1 in 28 cases(93.3%). Twenty-five patients were followed up postoperatively from 12 months to 10 years.During the follow-up period, 8 ca-ses died, recurrence or metastasis occurred in 8 cases, and 9 cases remained in a stable condition.Conclusion GIST shows untypical clinical features.Raising awareness of GIST, avoiding misdiagnosis, timely surgical resection and targeted therapy are the major measures for improving the prognosis of GIST.%目的：探讨胃肠道间质瘤（ gastrointestinal stromal tumor，GIST）的临床特点、诊断和治疗方法。方法回顾性分析该院2004-06～2014-06收治的30例GIST患者的临床资料。结果 GIST病变部位为胃14例，十二指肠2例，小肠10例，结肠2例，直肠2例。30例均在术前通过影像学检查明确病灶部位。全部病例均行手术切除，其中行联合脏器切除2例，内镜下切除3例。术后均由病理学检查及免疫组织化学检测确诊。酪氨酸激酶受体（ CD117）阳性率为96.7％（29／30），DOG-1阳性率为93.3％（28／30），骨髓干细胞抗原（ CD34）阳性率为73.3％（22／30）。有效随访25例，随访12个月～10年，8例死亡，8例复发转移，9例病情稳定。结论 GIST的临床表现无特异性，提高对GIST的认识，减少误诊，积极的手术切除结合靶向治疗是改善其预后的主要措施。