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目的:探讨小肠间质瘤(stro-mal tumor of small intestine,SIST)的临床表现、病理特征及诊疗措施。方法:对1994-06-01-2006-06-30收治的47例SIST病例的临床资料进行回顾性分析。结果:本组病例表现为消化道出血38例,腹部疼痛或腹胀5例,腹部包块3例,肠梗阻1例。病理检查:良性18例(38.3%),交界性14例(29.8%),恶性15例(31.9%);肿瘤细胞由梭形细胞构成17例,上皮样细胞构成11例,多形细胞构成19例。本组患者均行手术治疗,手术切除不全(2例)、术后复发(5例)或远处转移(2例)的患者应用甲磺酸依马替尼(格列卫)辅助治疗。随访6个月~9年,5例患者死亡;11例患者术后复发及4例患者术后出现肝转移,7例服用格列卫治疗部分缓解;余27例健在,临床疗效满意。结论:SIST临床表现为消化道出血、腹部疼痛或腹部包块;对长期不明原因的消化道出血患者应及早行剖腹探查或腹腔镜腹腔探查明确诊断进行手术治疗;格列卫辅助治疗手术切除不全或术后复发的SIST具有较好的临床疗效。
Objective: To investigate the clinical manifestations, pathological features and diagnosis and treatment of stro-mal tumor of small intestine (SIST). Methods: The clinical data of 47 cases of SIST admitted from June 1994 to June 2006 were retrospectively analyzed. Results: This group of patients showed gastrointestinal bleeding in 38 cases, abdominal pain or bloating in 5 cases, 3 cases of abdominal mass, intestinal obstruction in 1 case. Pathological examination showed that benign tumors were found in 18 cases (38.3%), borderline in 14 cases (29.8%) and malignant in 15 cases (31.9%). Tumor cells consisted of spindle cells in 17 cases, epithelioid cells in 11 cases and polymorphonuclear cells in 19 example. The patients underwent surgical treatment, surgical resection (2 cases), postoperative recurrence (5 cases) or distant metastasis (2 cases) were treated with imatinib mesylate (Gleevec) adjuvant therapy. Five patients died after follow-up from 6 months to 9 years. Postoperative recurrence occurred in 11 patients and liver metastases occurred in 4 patients. Seven patients were treated with Gleevec partially and partially. All the remaining 27 patients were alive and the clinical outcome was satisfactory. Conclusions: The clinical manifestations of SIST are gastrointestinal bleeding, abdominal pain or abdominal mass. Patients with long-term unexplained gastrointestinal bleeding should be treated with laparotomy or laparoscopic abdominal exploration as early as possible. Surgical treatment of Gleevec adjuvant surgery Or postoperative recurrence of SIST has better clinical efficacy.