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目的：探讨胃间质瘤(GST)的临床特点、诊断和治疗方法。方法：回顾分析37例经手术证实的胃间质瘤的临床资料。结果：GST的临床表现无特异性,消化道出血是最常见的症状(16/37),其次是上腹部隐痛不适、腹部肿块。术前胃镜、胃造影和CT扫描确诊率低,分别是4/37,1/34和0/17。本组切除率100%,无手术死亡。手术方式包括胃壁局部切除4例；胃大部切除18例；根治性胃大部切除12例；全胃切除3例,其中联合脏器切除2例。术后随访3～10年,随访34例,失访3例。结论：GST具有独特的组织学形态,术前确诊较为困难,免疫组化检测可确诊。术中仔细探查肿瘤的大小、生长方式、有无坏死溃疡和周围淋巴结肿大,有助于判断肿瘤的良恶性。良性和潜在恶性GST可行胃壁局部切除或胃大部切除术,恶性GST应行根治性胃大部切除或全胃切除,如有淋巴结转移,至少行区域淋巴结清扫术。
Objective: To investigate the clinical features, diagnosis and treatment of gastric stromal tumors (GST). Methods: A retrospective analysis of 37 cases of clinically confirmed gastric stromal tumor clinical data. Results: The clinical manifestations of GST were nonspecific. Gastrointestinal hemorrhage was the most common symptom (16/37), followed by painful upper abdominal discomfort and abdominal mass. Preoperative gastroscopy, gastric angiography and CT scan confirmed the low rates were 4/37, 1/34 and 0/17. The resection rate of 100%, no operative death. Surgical methods included partial resection of the stomach wall in 4 cases; subtotal gastrectomy in 18 cases; radical gastrectomy in 12 cases; total gastrectomy in 3 cases, of which 2 cases of combined organ resection. After 3 to 10 years of follow-up, 34 cases were followed up and 3 cases were lost to follow-up. Conclusion: GST has a unique histological morphology, preoperative diagnosis is more difficult, immunohistochemical detection can be confirmed. Intraoperative careful exploration of tumor size, growth patterns, with or without necrotic ulcers and surrounding lymph nodes, helps to determine the benign and malignant tumors. Benign and potentially malignant GST feasible gastric resection or subtotal gastrectomy, malignant GST should be performed radical gastrectomy or total gastrectomy, if lymph node metastasis, at least regional lymph node dissection.