30例胃肠道间质瘤外科诊治分析.doc

30例胃肠道间质瘤外科诊治分析 黄鹏 邹卫华 童庆华 黎朝良 袁来顺 姜斌（武汉市江夏区第一人民医院肝胆外科，湖北 武汉 430200) 【摘要】　目的　探讨胃肠道间质瘤（GIST）的临床特点、诊断和治疗方法。 方法　回顾性分析本院2004年6月至2016年6月收治的30例胃肠道间质瘤患者的临床资料。 结果 本组 GIST 病变部位：胃19例，十二指肠2例，小肠6例，结肠2例，直肠1例。30例均在术前通过影像学检查明确病灶部位。本组全部病例均行手术切除，其中2例行联合脏器切除，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。 【关键词】: 胃肠间质瘤；诊断；外科手术；靶向治疗 作者单位：430200 湖北武汉，武汉市江夏区第一人民医院肝胆外科 Surgical diagnosis and treatment of gastrointestinal stromal tumor: an analysis of 30 cases HUANG Peng ZOU Weihua TONG Q inhua LI zhaoliang YUAN Laishun JIANG Bin(Department of Hepatobiliary Surgery, The First peoples Hospital of Jiangxia, Wuhan 430200, China) 【Abstract】　Objective　To discuss clinical characteristics，diagnosis and treatment of gastrointestinal stromal tumor. Methods Clinical data of 21 patients with gastrointestinal stromal tumor who were admitted between June 2004 and June 2016were analyzed retrospectively. Results In the 30 patients with GIST,19 cases were located in stomach,2 cases in intestine，6 case in colon, 2 case in rectum and 1 case in duodenum. All patients focus locus were identified by imaging examination. All patients underwent complete resections，including multiorgan resection and endoscopic resection in 3 patient respectively.After operation, the diagnosis was confirmed through pathological examination and immunohistochemistry. Immunohistochemistry demonstrated that tumor cells were positive for CD117 in 29 cases (96.7%) , for CD34 in 22 cases (73.3%) and fo DOG-1 in 28 cases (93.3%). 25 patients were followed up postoperatively from 12 months to 10 years. During the follow-up period, 8 cases died,8 patients occurred recurrence or metastasis,and 9 cases were stable. Conclusions GIST shows typical clinical features，heightened awareness about GIST, avoidance of misdiagnosis, positive surgical resection and targeted therapy