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目的探讨胃肠道间质瘤(GIST)的诊断、免疫组化特点、良恶性的判断和治疗。方法回顾性总结分析47例GIST的临床和病理资料。结果本组GIST位于胃30例,小肠13例,结肠3例,肛管1例;28例行胃镜检查,确诊4例,发现病灶21例,8例行超声胃镜并穿刺活检,6例确诊;CD117阳性率为82.97%(39/47),CD34阳性率为93.61%(44/47);病理诊断良性间质瘤13例,交界性7例,恶性27例。本组均行肿瘤局部切除或局部消化道部分切除,获得随访的11例良性间质瘤患者全部存活,24例恶性及6例交界性间质瘤患者1例复发,3例发生转移,8例死亡。结论超声内镜结合胃肠道影像学检查是临床诊断的主要方法,确诊需依靠组织病理学检查和免疫组化染色,手术局部切除是有效的治疗手段。
Objective To investigate the diagnosis, immunohistochemical characteristics, diagnosis and treatment of gastrointestinal stromal tumors (GIST). Methods Retrospective analysis of 47 cases of GIST clinical and pathological data. Results The group of GIST was located in the stomach of 30 cases, 13 cases of small intestine, 3 cases of colon, 1 case of anal canal; 28 cases of gastroscopy, diagnosed in 4 cases, found lesions in 21 cases, 8 cases underwent endoscopic ultrasonography and biopsy, 6 cases confirmed; The positive rate of CD117 was 82.97% (39/47) and the positive rate of CD34 was 93.61% (44/47). Pathological diagnosis of benign stromal tumors in 13 cases, borderline in 7 cases, malignant in 27 cases. This group of patients underwent local excision of the tumor or partial partial resection of the digestive tract, were followed up 11 cases of benign stromal tumors were all survived, 24 cases of malignant and 6 cases of borderline stromal tumors in 1 case of recurrence, 3 cases of metastasis, 8 cases death. Conclusion Ultrasound endoscopy combined with gastrointestinal imaging is the main method of clinical diagnosis. The diagnosis depends on histopathological examination and immunohistochemical staining. Local excision is an effective treatment.