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目的探讨胃肠道间质瘤(gastrointestinal stromaltumor,GIST)和胃肠道外间质瘤(extragastrointestinal stromaltumor,EGIST)的临床病理和免疫组化特点及其诊断标准。方法回顾性分析天津医科大学总医院及第二医院2000—2009年已确诊的216例GIST和EGIST病人的临床资料,其中,天津医科大学总医院175例,天津医科大学第二医院41例。结果 216例病人中,男性112例,女性104例,男女比例为1.077:1;发病年龄15～91岁,中位年龄58岁;肿瘤原发于胃肠道者182例,以胃多见;胃肠道外者34例,以肠系膜多见。肿瘤直径0.8～30.0cm,由梭形细胞和上皮样细胞组成,细胞排列呈交叉束状、漩涡状及巢状。214例CD117呈阳性。临床多表现为消化道出血、腹部疼痛、腹部肿块及肠梗阻等症状。结论 GIST较EGIST多见;胃肠道以中、高度危险者多见,胃肠道外以高度危险者多见。临床治疗原则首选广泛手术切除。
Objective To investigate the clinicopathological and immunohistochemical features and diagnostic criteria of gastrointestinal stromal tumor (GIST) and extragastrointestinal stromal tumor (EGIST). Methods The clinical data of 216 cases of GIST and EGIST diagnosed from 2000 to 2009 in General Hospital of Tianjin Medical University and the second hospital were retrospectively analyzed. Among them, 175 cases were from Tianjin Medical University General Hospital and 41 cases from the Second Hospital of Tianjin Medical University. Results Of the 216 patients, 112 were males and 104 were females, the odds ratio was 1.077: 1. The age of onset was 15-91 years and the median age was 58 years. The tumors were mainly located in the gastrointestinal tract and 182 cases, 34 cases of gastrointestinal tract to mesenteric more common. Tumor diameter 0.8 ~ 30.0cm, by the spindle cells and epithelial cells, cells arranged in a cross-beam, swirling and nested. 214 cases of CD117 positive. Clinical manifestations of gastrointestinal bleeding, abdominal pain, abdominal mass and intestinal obstruction and other symptoms. Conclusion GIST is more common than EGIST. Gastrointestinal tract is more common in patients with medium and high risk, and people with high risk of gastrointestinal disease are more common. The principle of clinical treatment preferred a wide range of surgical resection.