消化道颗粒细胞瘤临床的的特点及疗效分析.docVIP

消化道颗粒细胞瘤临床的的特点及疗效分析 　　[摘要] 目的 分析消化道颗粒细胞瘤（GCT）患者的临床特征，对治疗效果进行分析。方法 回顾分析 2012年 12月～2016年10月在我院住院的5 例消化道 GCT患者的临床资料，分析其临床特征，治疗效果。结果5 例消化道 GCT 患者中，食管 GCT4 例（其中1例合并早期食管癌），盲肠 GCT 1例，所有患者均表现为非特异性消化道症状或无消化道症状，均行术前内镜及超声内镜检查诊断为消化道黏膜下隆起性病变，分别疑诊脂肪瘤、 类癌及异位胰腺。1例术前考虑消化道 GCT，5例患者术前均未活检，4例行内镜下黏膜剥离术（ESD），1例行单环套扎+圈套器切除，术后病理及免疫组化分析显示肿瘤细胞均表达 S-100，确诊为消化道 GCT，未见明显恶性特征，术后随访3～48个月，均无复发及转移。结论 消化道GCT 可无特异性消化道症状、发病率低，内镜下亦无特异性表现，因此明确诊断仍依赖于病理结果，对于2cm 的黏膜下 GCT，内镜下治疗效果好，但需长期随访，排除恶变可能。 　　[关键词] 消化道；颗粒细胞瘤；特点 　　[中图分类号] R735 [文献标识码] A [文章编号] 2095-0616（2017）06-154-04 　　[Abstract] Objective To explore the clinical characteristicas of granular cell tuomr， and to analyze the curative effect. Methods Data of 5 cases of GCT patients cured in our hospital from December 2012 to October 2016 were retrospectively analyzed. The clinical characteristics and therapeutic effect were analyzed. Results Among the 5 cases of GCT patients， there were GCT4 cases of esophagus（1 cases with early esophageal cancer） and GCT of cecum in 1 cases. All patients presented with nonspecific gastrointestinal symptoms or no gastrointestinal symptoms. All cases were diagnosed by endoscopic and endoscopic ultrasonography， and they respectively were lipoma， carcinoid and ectopic pancreas. 1 cases of gastrointestinal tract GCT were considered before operation， and all of the 5 patients had no biopsy before operation， and endoscopic mucosal resection（ESD） was performed in all of the 4 patients， and the other cases were treated with single loop ligation and snare excision（n=1）. Postoperative pathological and immunohistochemical analysis showed that the tumor cells all expressed S-100， which was diagnosed as digestive tract GCT， and there was no obvious malignant feature. No recurrence and metastasis were observed after 3-48 months of follow-up. Conclusion There are no specific gastrointestinal symptoms and low incidence of GCT in the digestive tract. Therefore， the definite diagnosis depends on pathological results. For less than 2cm