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目的探讨胃肠道间质瘤的临床特点、治疗方法,提高诊断和治愈率。方法回顾分析2001～2009年间31例胃肠道间质瘤患者的临床诊断、治疗及病理资料。结果 GIST好发于胃和小肠,临床表现缺少特异性,病理免疫组化是GIST诊断与鉴别诊断的决定条件,CD117和CD34为其重要标志物,80%～100%的GIST肿瘤细胞中CD117呈弥漫阳性表达,60%～80%的GIST肿瘤细胞中CD34呈弥漫阳性表达。CT能直接观察间质瘤的大小、密度及侵犯和转移情况。内镜超声能提供高分辨率图像,发现直径小于2cm的肿瘤。手术完整切除是主要治疗方法。结论在区别GIST与平滑肌瘤或神经源性肿瘤时,CD117、CD34表达特异性强,具有重要价值。CT、内镜超声检查是目前诊断GIST常用和重要的手段,手术切除是有效的治疗方法,甲磺酸伊马替尼辅助治疗能够明显地提高患者的无复发生存率。
Objective To investigate the clinical features, treatment of gastrointestinal stromal tumors and to improve the diagnosis and cure rate. Methods The clinical diagnosis, treatment and pathological data of 31 patients with gastrointestinal stromal tumors from 2001 to 2009 were retrospectively analyzed. Results GIST developed in the stomach and small intestine. The clinical manifestations were lack of specificity. Pathological immunohistochemistry was the determining factor for the diagnosis and differential diagnosis of GIST. CD117 and CD34 were important markers of GIST. Among 80-100% GIST tumor cells, CD117 Diffuse positive expression, 60% ~ 80% of GIST tumor cells were diffuse positive expression of CD34. CT can directly observe the size, density and invasion and metastasis of stromal tumors. Endoscopic ultrasonography provides high-resolution images of tumors less than 2 cm in diameter. Complete surgical removal is the main treatment. Conclusion In distinguishing GIST from leiomyoma or neurogenic tumor, the expression of CD117 and CD34 is of high specificity and valuable. CT, endoscopic ultrasonography is currently used to diagnose GIST common and important means of surgical resection is an effective treatment, adjuvant imatinib mesylate treatment can significantly improve the patient’s recurrence-free survival.