小肠间质瘤46例临床特点及治疗_临床医学论文.docVIP

小肠间质瘤46例临床特点及治疗_临床医学论文 小肠间质瘤46例临床特点及治疗_临床医学论文 作者：林克荣，刘建强，张志坚 　　【Abstract】AIM: To explore the clinical characteristics and diagnosis and therapeutic method of gastrointestinal stromal tumors of the small intestine. METHODS: Clinical data of 46 cases of gastrointestinal stromal tumors of the small intestine admitted 199206/200606 were analyzed retrospectively. The diagnosis was confirmed pathologically for all cases. RESULTS: Gastrointestinal stromal tumors of the small intestine attacked both male and female, with the male to female ratio as 1.21∶1.The age of the patients ranged from 19 to 80 (average 53) years. The age stage with the highest occurrence rate located at 45-60 years. The major clinical signs included: abdomen pain, abdomen mass, anaemia and small bowel obstruction. The gastrointestinal stromal tumors of the small intestine had predilection in the jejunum and duodenum. The detection rate could be enhanced by PETCT. The most effective therapy was operation removal of the tumors. Glivec might be helpful for patients who had palliative operation or in preventing recurrence. Reoperation could prolong the patients survival, who had local recurrence or distant metastasis. CONCLUSION: The clinical manifestations of gastrointestinal stromal tumors of the small intestine are nonspecific. The detection rate can be improved by rational auxiliary examinations. The most effective therapy is operation removal. 　　【Keywords】 mesothelioma; intestinal neoplasms; intestine, small 　　【摘要】目的： 探讨小肠间质瘤的临床表现、诊断及治疗方法. 方法： 对1992收治的46例小肠间质瘤的临床资料进行回顾性分析，所有病例均经手术和病理证实. 结果： 小肠间质瘤男女均有发病，男女比为1.21∶1. 本组发病年龄19～80(平均53)岁, 45～60岁年龄段发病率最高. 腹痛、腹部包块、贫血、小肠梗阻是本组最常见的临床表现. 小肠间质瘤多好发于空肠和十二指肠，PET可提高小肠间质瘤检出率. 手术彻底切除病变，格列卫对于姑息手术者或对预防术后复发有较好的疗效. 对复发或远处转移者再次手术可延长生存期. 结论： 小肠间质瘤临床表现缺乏特异性；合理应用辅助检查方法可提高小肠间质瘤检出率；手术为本病目前的最佳选择. 　　【关键词】 间皮瘤；肠肿瘤；小肠 　　0引言 　　胃肠道间质瘤( gastrointestinal stromal tumor, GIST)是一种发生于消化道，起源于胃肠道壁Cajal细胞（ICC）或与Cajal细胞同源的间叶干细胞的梭形细胞肿瘤，发病率约2/10万，平均发病年龄约60岁［1］. GIST大多发生在胃，占60%～70%，小肠