摘要
目的 总结胃肠道间质瘤的诊断与治疗经验。方法 回顾性总结分析27例胃肠道间质瘤的临床和病理资料。结果 本组胃间质瘤21例,十二指肠间质瘤4例,小肠间质瘤2例。临床表现为消化道出血者16例(59.3％),其中腹痛伴消化道出血者7例;腹痛13例(48.1％),其中上腹部疼痛者6例;以腹部肿块就诊者5例(18.5％)。25例行胃镜检查,确诊为间质瘤2例,发现病变部位22例。2例伴消化道大出血者急诊数字式减法血管造影(DSA)发现病变部位。病理诊断为良性间质瘤12例、交界性13例、恶性2例;良性间质瘤核分裂像和肿瘤直径均显著小于交界性和恶性者(P<0.05)。本组均行手术局部切除治疗,术后发生肺部感染2例,胃排空障碍1例。21例患者术后随访3～24个月,除1例小肠恶性间质瘤患者术后20个月腹壁切口复发外,其余20例均无肿瘤转移复发。结论 内镜和影像学检查对胃肠道间质瘤病变定位有重要作用,胃肠道间质瘤的确诊依靠病理学检查。手术局部切除是治疗胃肠道间质瘤的有效手段。
Objective To sum up the experience of diagnosis and treatment of gastrointestinal stromal tumors(GISTs). Methods The clinical and pathologic data of 27 patients with GISTs were analyzed retrospectively. Results Among 27 cases of GISTs, twenty-one cases originated in the stomach, 4 cases in the duodenum and 2 cases in the small intestine. Six patients with GISTs presented with upper abdominal pain, nine patients with gastrointestinal bleeding, seven cases with both abdominal pain and gastrointestinal bleeding, and five cases with abdominal mass. Gastrescopy was performed in 25 cases, lesions were found in 22 cases and preoperative diagnosis was made only in 2 cases. Emergency angiography was used to detect lesions in two cases with alimentary tract hemorrhage. Pathology revealed 12 benign cases, 13 borderline and 2 malignant cases. The mitoses and size of benign tumors were significantly lower than those of borderline and malignant tumors (all P<0.05). All the patients were treated by surgical local resection. The postoperative complications included 2 cases of pulmonary infection and one gastric emptying dysfunction. 21 cases were followed up from 3 to 24 months and no recurrence and metastasis were found except one case of incision recurrence. Conclusions Endoscopy and image examinations play an important role in detecting lesions of GISTs, but their final diagnoses depend on pathological examination. Surgical local resection is the effective treatment procedure for GISTs.
出处
《中华胃肠外科杂志》
CAS
2003年第5期292-294,共3页
Chinese Journal of Gastrointestinal Surgery
