临床研究性论著样稿.docVIP

胃肠间质瘤28例诊治分析 刘勇1崔乃强2300380；2.天津市南开医院全国中西医结合胆胰疗中心天津 300100探讨胃肠间质瘤GIST）的临床诊断、治疗和预后。回顾性分析南开医院2002年1月2007年9月收治的胃肠间质瘤28例临床资料及其病理免疫组化结果。肿瘤部位以胃肠为主，本组均行手术治疗。术后病理诊断10例良性，18例为潜在恶性和恶性免疫组化CD34阳性19例67.9%），CD117阳性28例100%），抗平滑肌抗体SMA）阳性13例46.4%），而S-100阳性1例（3.6%）。胃间质瘤中CD34表达率在良性肿瘤与恶性肿瘤之间以及交界性肿瘤与恶性肿瘤之间表达差异有显著性意义P0.05）。术后随访良性GIST 10例，平均随访时间25.6个月，8例无局部复发、转移2例术后1年内复发再手术恶性GIST 18例，平均随访18.5个月，9例局部复发再手术，5例肝肺转移，4例死亡。CD34可能在胃间质瘤的发生、发展过程发挥重要作用。手术完全切除对于GIST是主要的治疗方法。肿瘤大小及核分裂像数目是GIST重要的预后因素。 胃肠间质瘤；免疫组织化学；诊断；治疗刘勇（1971-），男，天津市人，主治医师，硕士，主要从事普通外科临床与基础的研究。@163.com [收稿日期] 2009-02-10 [修回日期] 2008-03-15 Study on diagnosis and treatment of gastrointestinal stromal tumors in 28 cases LIU Yong, CUI Nai-qiang (Tianjin Medical University, Tianjin 300380, China) Abstract: Objective To study the diagnosis and treatment of gastrointestinal stromal tumors (GIST). Methods The clinical data of 28 patients with GIST admitted into surgical department from January 2003 to September 2008 were retrospectively analyzed. Results The resection of gastrointestinal stromal tumors was undertaken in 28 cases. Stomach and small-bowel were often affected by this tumor. The tumors were benign in 10 cases and malignant in 18 cases. The expression of CD34 and CD117 had been seen in 19 cases (67. 9% ) and 28 cases (100% ) respectively with immunohistochemical staining. But the expression of for SMA and S-100 in all cases were 13 cases (46.4%) and 1case (3.6%). There was a significant difference of CD34 expression between in benign tumor and in gastric tumors (P0.05). Benign GIST in 10 cases were followed-up for average 25.6 months，8 of them had no local recurrence and metastasis, 2 cases of them relapsed and operated again. Malignant GIST in 18 cases were followed-up for average 18.5 months，9 of them with local recurrence were t reated with re-operation 5 case of them had liver and lung metastasis, and 4 cases died. Conclusion CD34 might play roles in the process of carcinogenesis of gastric tumors. Gastrointestinal stromal tum