胃肠间质瘤的临床诊治

【摘要】 目的  探讨胃肠间质瘤的临床诊断和治疗方法。 方法  回顾分析我院近期收治的7例胃肠间质瘤患者的临床资料。 结果  本组7例患者中胃部肿瘤3例，小肠肿瘤3例，直肠肿瘤1例。良性1例，潜在恶性2例，恶性4例。根治性切除5例，姑息性切除2例。免疫组化示CD117、CD34、Vimentin多为弥漫阳性，SMA、S-100多为阴性。 结论  胃肠间质瘤术前不易确诊，根治性外科切除是最有效的治疗方法。
    
　　【关键词】  胃肠道间质瘤;诊断;治疗
 
　Clinical diagnosis and treatment of gastrointestinal stromal tumors
 

    【Abstract】 Objective To investigate the diagnosis and treatment of gastrointestinal stromal tumors.Methods The clinical date of7patients with gastrointestinal stromal tumors were reviewed.Results The group included4males and3females whose age ranged from41to81years.3tumours originated in the stomach，3cases in small bowel，1case was in rectum.1case was benign.2cases were potential malignant，4cases were malignant tumors.Radical operation was performed on5cases and palliative operation was performed on2cases.Immunohistochemical staining results:CD117，CD34and Vimentin showed diffuse strong expression mostly，and SMA，S-100negative expression mostly.Conclusion Preoperative diagnosis of gastrointestinal stromal tumors is difficult.Radical resection is the most effec-tive treatment.
   
　　【Key words】 gastrointestinal stromal tumors;diagnosis;treatment
      
　　胃肠间质瘤（gastrointestinal stromal tumors，GISTs）是临床上较常见的肿瘤，是一种来源于胃肠道原始间质细胞的缺乏分化或未定向分化的非上皮性肿瘤，是消化道独立的一类间叶性肿瘤 ［1］ 。本文分析我院近期收治的7例GISTs临床资料，结合相关文献，探讨GISTs的临床诊断及治疗。

　　1 临床资料
    
　　1.1 一般资料 本组7例患者均经手术切除及术后病理证实，男4例，女3例;年龄41～81岁（平均56.3岁）。临床表现首发症状为中上腹部疼痛或不适2例，黑便伴贫血1例，腹部包块1例，排便障碍1例，偶然发现2例（妇科手术中）。