摘要
目的：探讨胃肠道间质瘤的临床病理诊断与治疗方法。方法：回顾性分析100例胃肠道间质瘤的临床病理资料。结果：CT平扫探查发现所有患者肿块均为单发，79例良性肿块可见软组织密度肿块，密度均匀；21例恶性肿块内可见大小不等的低密度坏死区，呈分叶状。双期增强扫描见肿块腔内侧大小不一的溃疡，其中7例恶性间质瘤的溃疡程度大而深；增强扫描肿块呈不均匀明显强化，囊变坏死区无强化。病变发生在胃部56例，十二指肠26例，小肠10例，结肠及直肠6例，肠系膜2例。术中标本的病理学检测发现由梭形瘤细胞形成的细胞团巢是胃肠道间质瘤的特征排列。所有病例均完整切除，均未发现淋巴结转移，术中及术后均无死亡，平均住院时间15．2d。随访期6～24个月，其中5例恶性肿瘤患者死亡，均死于肝转移；28例复发（28．0％），其中肿瘤类型：交界性肿瘤12例，恶性肿瘤16例；复发部位：局部复发16例，腹膜复发12例；再次进行切除手术后随访3个月，均存活。结论：胃肠道间质瘤可根据其临床表现、CT等影像学检查以及病理学检测等明确诊断，早行手术切除效果良好。
Objective： To investigate the clinicopathological diagnosis and management of gastrointestinal stromal tumors （GISTs）. Methods： The clinicopathological data of 100 GISTs patients were retrospectively analyzed. Results： All patients had a single lesion on CT scan, of whom 79 cases had a benign lesion that presented as soft tissue mass with uniform density, and 21 cases had malignant tumor that showed a lobulated mass with low-density necrotic areas of variable sizes inside. 3-he dual-phase contrast-enhanced CT scan demonstrated that there were ulcers of varying sizes in the tumor cavity, and the ulcers in 7 cases of malignant tumor were large and deep. The masses were heterogeneously enhanced under contrast-enhanced CT scan, and no enhancement was seen in the cystic necrotic area. The lesions of 56 cases were located in the stomach,26 cases in the duodenum, 10 cases in the small bowel, 6 cases in the colon and rectum, and 2 cases in the mesentery. The pathological examination of the surgical specimens showed cell nests composed of spindle- shaped tumor cells with the typical arrangement of GISTs. All patients underwent complete resection, no lymph node metastasis was found and no intraoperative or postoperative death occurred. The average length of hospitalization was 15.2 d. The follow-up period ranged from 6 months to 24 months, during which time 5 malignant GIST patients died and all the the deaths were due to liver metastases; tumor recurrence occurred in 28 patients （28%）, of whom 12 cases were borderline tumors and 16 cases were malignant tumors; 16 cases had local recurrence and 12 cases had peritoneal recurrence. M1 of the recurrent cases were alive during the 3-month follow-up period after a second resection. Conclusion： The diagnosis of GISTs depends on the clinical manifestations, CT scan findings and pathological examination, and GISTs may have better outcomes after early surgical resection.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2012年第10期1266-1269,共4页
China Journal of General Surgery
关键词
胃肠道间质瘤
外科学
胃肠道间质瘤/诊断
X线影像增强
Gastrointestinal Stromal Tumors/surg
Gastrointestinal Stromal Tumors/diag
Radiographic ImageEnhancement
