摘要
目的探讨胃间质瘤的诊断和治疗方法。方法对本院1995—08～2005—08收治的经手术病理证实的19例胃间质瘤进行回顾性研究。结果本组19例病人表现为上腹部隐痛不适11例，消化道出血3例，无症状性上腹部肿物5例。术前经上消化道造影、胃镜、CT等检查诊断为胃间质瘤13例，其中取得病理诊断者仅4例。肿瘤位于贲门胃底区7例，胃体9例，胃窦3例。肿瘤最小2．0cm，最大25cm，中位大小6．0cm。胃周淋巴结转移1例。手术行胃契形切除11例，近端胃大部切除5例，远端胃大部切除3例，其中联合脏器切除3例。检测免疫组化CD117阳性16例，CD34阳性17例。术后随诊5例复发转移。结论胃间质瘤术前诊断主要靠胃镜、上消化道造影和CT联合检查，如能结合超声内镜下穿刺活检（EUS—FNA），将会得到更多组织学证据。治疗以手术为主，切除在于完全而不在于大范围清扫。辅以分子靶向药物治疗将有效改善预后。
Objective To investigate the diagnosis and treatment of gastric stromal tumors （GST）. Methods The clinical data of 19 cases with GST were analyzed retrospectivdy. Results The main symptoms were abdominal pain（11/19）,GI bleeding （3/19） and mass （5/19）.Tomors were found by gastroscopy, barium meal and computer tomography. The preoperational diagnosis of GST was 13 cases, and only 4 with pathological evidences. All cases underwent resection, of which wedged resection in 11 cases, distal subtotal gastrectomy in 3 cases, proximal gastrectomy in 5 cases, conbined with other organs resection in 3 cases. GST located at cardia and gastric fundus in 7 cases, gastric body in 9 cases and gastric antrum in 3 cases. Diameter of tumors was from 2 cm to 25 cm. Only one case had perigastric lymph node metastasis. Immunohistochemistry staining showed CD117 positive in 16 cases,CD34 positive in 17 cases. 15 of 19 cases were followed up from 6 to 62 months.5 cases recurred or metastasized. Conclusion The diagnosis of GST is difficult and mainly depends on the combinition of gastroseopy,barium meal and computer tomography. Especially combined with EUS- FNA, we＇ll make more pathological diagnosis. Surgical approcch remains the major treatment for GST. Complete resection and prevention of tumor rupture should be focused on during the operation. No routine lymphatic clearance be required.
出处
《黑龙江医学》
2006年第9期657-659,共3页
Heilongjiang Medical Journal
关键词
胃肿瘤
间质瘤
诊断
治疗
Stomach neoplasms
Stromal tumors
Diagnosis
Treatment
