目的 探討胃腸道間質(zhì)瘤(GIST)的臨床表現(xiàn)及診治方法。
方法 回顧性分析2003~2008年期間我院收治的35例GIST患者的臨床表現(xiàn)和隨訪(fǎng)資料。
結(jié)果 GIST發(fā)生部位:胃22例(62.8%),小腸8例(22.9%),結(jié)直腸2例(5.7%),腹膜后或腸系膜3例(8.6%)。免疫組織化學(xué)檢測(cè)顯示,CD117 (+) 32例(91.4%),CD34 (+) 18例(51.4%),SMA (+) 4例(11.4%),S100 (+) 2例(5.7%)。35例患者均接受了手術(shù)治療,其中根治性手術(shù)30例,非根治性手術(shù)5例,聯(lián)合臟器切除10例。隨訪(fǎng)中位時(shí)間34個(gè)月,隨訪(fǎng)率為100%(35/35)。全組患者1、3、5年累積生存率分別為95.4%、87.2%和77.9%。本組患者中有3例術(shù)后復(fù)發(fā)轉(zhuǎn)移患者服用甲磺酸伊馬替尼的患者至今仍帶瘤生存?;颊叩?年累積生存率與腫瘤大小、有無(wú)腫瘤壞死、核分裂數(shù)、腫瘤細(xì)胞核異型性、腫瘤部位及手術(shù)方式有關(guān)(P<0.05 )。
結(jié)論 GIST主要通過(guò)術(shù)后病理和免疫組織化學(xué)檢測(cè)明確診斷,完整的局部手術(shù)切除是最有效的治療手段,復(fù)發(fā)轉(zhuǎn)移病例需要手術(shù)與藥物治療的結(jié)合。
引用本文: 丁志,趙平,周祥,唐令超. 35例胃腸道間質(zhì)瘤臨床診治分析. 中國(guó)普外基礎(chǔ)與臨床雜志, 2012, 19(11): 1235-1237. doi: 復(fù)制
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2. | Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors:A consensus approach[J]. Hum Pathol, 2002, 33(5):459-465. |
3. | Miettinen M, Blay JY, Sobin LH. Mesenchymal tumors of the stomach//Hamilton SR, Aaltonen LA, ed. World Health Organi-zation classification of tumours. Pathology and genetics oftumours of the digestive system[M]. Lyon:IARC Press, 2000:62-65. |
4. | Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors:recent advances in understanding of their biology[J]. Hum Pathol, 1999, 30(10):1213-1220. |
5. | DeMatteo RP, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumors:recurrence patterns and prognostic factorsfor survival[J]. Ann Surg, 2000, 231(1):51-58. |
6. | Rossi CR, Mocellin S, Mencarelli R, et al. Gastrointestinal stromal tumors:from a surgical to a molecular approach[J]. Int J Cancer, 2003, 107(2):171-176. |
7. | Clary BM, DeMatteo RP, Lewis JJ, et al. Gastrointestinalstromal tumors and leiomyosarcoma of the abdomen and retroperitoneum:a clinical comparison[J]. Ann Surg Oncol, 2001, 8(4):290-299. |
8. | Blay JY, BonvalotS, Casali P, et al. Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO[J]. Ann Oncol, 2005, 16(4):566-578. |
9. | Plaat BE, Hollema H, Molenaar WM, et al. Soft tissue leiomyosarcomas and malignant gastrointestinal stromal tumors:differences in clinical outcome and expression of multidrug resistance proteins[J]. J Clin Oncol, 2000, 18(18):3211-3220. |
10. | Ng EH, Pollock RE, Munsell MF, et al. Prognostic factors influencing survival in gastrointestinal leiomyosarcomas. Implications for surgical management and staging[J]. Ann Surg, 1992, 215(1):68-77. |
- 1. 胃腸道間質(zhì)瘤中國(guó)專(zhuān)家組. 胃腸道間質(zhì)瘤診斷與治療中國(guó)專(zhuān)家共識(shí)[J]. 中華胃腸外科雜志, 2009, 12(5):536-539.
- 2. Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors:A consensus approach[J]. Hum Pathol, 2002, 33(5):459-465.
- 3. Miettinen M, Blay JY, Sobin LH. Mesenchymal tumors of the stomach//Hamilton SR, Aaltonen LA, ed. World Health Organi-zation classification of tumours. Pathology and genetics oftumours of the digestive system[M]. Lyon:IARC Press, 2000:62-65.
- 4. Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors:recent advances in understanding of their biology[J]. Hum Pathol, 1999, 30(10):1213-1220.
- 5. DeMatteo RP, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumors:recurrence patterns and prognostic factorsfor survival[J]. Ann Surg, 2000, 231(1):51-58.
- 6. Rossi CR, Mocellin S, Mencarelli R, et al. Gastrointestinal stromal tumors:from a surgical to a molecular approach[J]. Int J Cancer, 2003, 107(2):171-176.
- 7. Clary BM, DeMatteo RP, Lewis JJ, et al. Gastrointestinalstromal tumors and leiomyosarcoma of the abdomen and retroperitoneum:a clinical comparison[J]. Ann Surg Oncol, 2001, 8(4):290-299.
- 8. Blay JY, BonvalotS, Casali P, et al. Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO[J]. Ann Oncol, 2005, 16(4):566-578.
- 9. Plaat BE, Hollema H, Molenaar WM, et al. Soft tissue leiomyosarcomas and malignant gastrointestinal stromal tumors:differences in clinical outcome and expression of multidrug resistance proteins[J]. J Clin Oncol, 2000, 18(18):3211-3220.
- 10. Ng EH, Pollock RE, Munsell MF, et al. Prognostic factors influencing survival in gastrointestinal leiomyosarcomas. Implications for surgical management and staging[J]. Ann Surg, 1992, 215(1):68-77.