Clinical analysis of gastrointestinal stromal tumor

目的 探讨胃肠道间质瘤(GIST)的临床特点及病理特征,以提高临床医生对该疾病早期的诊断,减少误诊和漏诊.方法 回顾性分析45例手术治疗的GIST患者的临床表现、辅助检查、手术病理及免疫组化结果.结果 45例中,男18例,女27例；年龄24～85岁,中位年龄62岁.以消化道出血及贫血为主要症状的患者14例(31.1％),腹痛患者9例(20.0％),腹部不适者7例(15.6％).GIST部位:胃25例(55.6％),小肠15例(33.3％),腹腔3例,食管1例,直肠1例.CD117阳性率97.8％ (44/45),CD34阳性79.5％ (35/44).腹部CT检查的诊断率为78.4％ (29/37).胃镜对于胃GIST的检出率较高,为91.3％(21/23).十二指肠球部及降部GIST,胃镜检查诊断率为3/5 (60.0％).超声内镜检查诊断率为100.0％(10/10).结论 GIST临床表现以腹痛和黑便为多,需慎重对待.CD117的阳性率高.胃镜对胃十二指肠GIST的发现率较高,但诊断率不高,超声内镜有较好的诊断率.Objective To investigate the clinical features,pathological features and diagnosis of gastrointestinal stromal tumor(GIST) ; to improve early clinical diagnosis and to reduce misdiagnosis.Methods All 45 patients with GIST in our hospital who had gone through surgery and confirmed by pathology were retrospectively analyzed,which included clinical symptoms,laboratories,histopathology and immunohistochemistry.Results Of 45 GIST patients,there were 18 males and 27 females with age of 24-85 years old; the median age was 62 years old.Gastrointestinal bleeding and anemia were in 14 patients (31.1％) ; abdominal pain was in 9 cases (20.0％) and abdominal discomfort was in 7 cases (15.6％).Tumor locations:stomach in 25 cases (55.6％),small intestine in 15 cases(33.3％),rectum in 1 case,esophagus in 1 case and abdominal cavity 3 cases.The positive rates of CD 117 and CD34 in GIST patients were 97.8 ％ (44/45) and 79.5 ％ (35/44),respectively.The diagnosis rate of CT examinations of the abdomen was 78.4％ (29/37).The detection rate of gastroscopy for gastric GIST was 91.3％ (21/23).To duodenal bulb and descending GIST,the diagnosis rate of gastroscopy was 60.0％ (3/5).The diagnosis rate of endoscopic ultrasound was 100.0％ (10/10).Conclusions Most clinical manifestations of GIST are abdominal pain and melena.The positive rate of CD117 is high.The detection rate of gastroscopy for gastric and duodenal GIST is high,but the diagnosis rate is not high.The diagnosis rate of endoscopic ultrasound is good.中国科技核心期刊(ISTIC)0101415-1417