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目的 探讨胃间质瘤的临床表现、诊断和治疗方法。方法 回顾分析资料完整、病理诊断明确的 31例胃间质瘤患者 ,依据诊断标准对胃间质瘤进行分类。结果 胃间质瘤无明显的性别差异 ,50～ 60岁为发病高峰。好发部位为胃底部 ,其次为胃体部 ,胃窦部发生较少。其中恶性胃间质瘤占 58 1 % (1 8/ 31 ) ,良性胃间质瘤仅占 2 5 8% (8/ 31 )。交界性胃间质瘤的病程较长 ,平均为 79个月 ,恶性胃间质瘤的病程较短 ,平均为 4个月。本病临床表现无特异性 ,主要为上消化道出血、上腹不适和 (或 )腹胀、腹痛等。胃镜、超声胃镜、上消化道钡餐造影或B超及CT影像学等检查可以发现肿瘤 ,通过病理组织学及免疫组化检查可明确诊断。本病首选手术治疗 ,对伴有肝转移者可采取经肝动脉导管栓塞化疗 ,但疗效不肯定。结论 胃间质瘤是一类独立的胃黏膜下肿瘤 ,过去诊断为平滑肌或神经源性肿瘤的某些梭形细胞肿瘤 ,通过免疫组化检查可能为胃间质瘤
Objective To investigate the clinical manifestations, diagnosis and treatment of gastric stromal tumors. Methods A retrospective analysis of 31 patients with complete histopathological diagnosis of gastric stromal tumors, according to the diagnostic criteria of gastric stromal tumors were classified. Results There was no significant gender difference in gastric stromal tumors, 50 to 60-year-old peak incidence. A good site for the bottom of the stomach, followed by the body of the stomach, less occurrence of gastric antrum. Among them, malignant gastric stromal tumor accounted for 58.1% (18/31), while benign gastric stromal tumors accounted for only 25.8% (8/31). Borderline stromal tumor of longer duration, with an average of 79 months, a shorter duration of malignant gastric stromal tumor, with an average of 4 months. The clinical manifestations of this disease is nonspecific, mainly upper gastrointestinal bleeding, abdominal discomfort and (or) abdominal distension, abdominal pain and so on. Gastroscopy, endoscopy, upper gastrointestinal barium meal angiography or B ultrasound and CT imaging and other tests can be found in the tumor, by histopathology and immunohistochemistry can confirm the diagnosis. The preferred surgical treatment of the disease, accompanied by liver metastasis may be taken through the hepatic artery catheter embolization chemotherapy, but the effect is not sure. Conclusions Gastric stromal tumors are an independent subset of gastric submucosal tumors that, in the past, were diagnosed as spindle-cell tumors of the smooth muscle or neurogenic tumors and were likely to have gastric stromal tumors by immunohistochemistry