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目的:研究旨在评价胃平滑肌肿瘤的生物学行为及其诊治。方法:收集1986～1995年间本科治疗患者,检出平滑肌起源胃肿瘤21例,复习病史、实验室检查、手术及病理报告,以比较良、恶性平滑肌肿瘤的临床特点、生物学活性及处置。结果:病理证实11例胃平滑肌瘤,9例肉瘤及1例子滑肌母细胞瘤。临床特点以腹痛(16/21)、呕血及血便(12/21),以及腹部包块(5/12),腹块主要见于恶性肿瘤中。肿瘤好发于胃体及胃底;肿瘤直径范围自0.5～15cm,肌瘤平均3.9cm,肉瘤平均7.8cm(P<0.05)。外科治疗的原则是局部切除肿瘤及周边2—3cm胃壁组织。在4例有转移的恶性肿瘤采用了姑息治疗措施。结论:区分平滑肌瘤及肉瘤主要标准是临床上局部浸润及转移以及组织学上的有丝分裂指数。肿瘤大于8cm恶性可能大,手术切除范围宜扩大。
Objective: To study the biological behavior and diagnosis and treatment of gastric smooth muscle tumors. Methods: Twenty-one patients with smooth muscle origin were diagnosed during the period from 1986 to 1995. The history, laboratory examinations, surgical and pathological reports were reviewed to compare the clinical features, biological activity and treatment of benign and malignant smooth muscle tumors. Results: Pathologically confirmed 11 cases of gastric leiomyoma, 9 cases of sarcoma and 1 case of glioblastoma. Clinical features include abdominal pain (16/21), hematemesis and bloody stool (12/21), and abdominal mass (5/12). The abdominal mass is mainly seen in malignant tumors. Tumors occurred in the corpus and stomach. The tumor diameter ranged from 0.5 to 15 cm, the average leiomyoma was 3.9 cm, and the average sarcoma was 7.8 cm (P < 0.05). The principle of surgical treatment is to locally resect the tumor and the surrounding 2-3cm stomach wall tissue. Palliative measures were used in 4 cases of metastatic malignant tumors. Conclusion: The main criteria for distinguishing leiomyoma and sarcoma are clinical infiltration and metastasis and histological mitotic index. Malignant tumors greater than 8cm may be large, surgical resection should be expanded.