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目的探讨胃肠道间质瘤(GISTs)临床、病理特点及预后情况。方法回顾性分析我院2000年1月至2004年2月收治的136例胃肠道间质瘤病例的临床和病理资料,并进行随访。结果GIST多发于胃(57.1%)和小肠(20.6%),结肠、直肠及腹腔内其他位置相对较少,临床常见症状为消化道出血(32.4%)、腹痛(25.0%)、腹部包块(21.3%)。就诊时已发生转移的17例,余119例获得了根治性切除或局部切除,手术切除率为87.5%(119/136)。术后转移复发率20.3%(15/74)。结论GIST临床表现无特异性,术前确诊困难,对于无转移的病人,手术切除是首选治疗方法,但术后转移复发率高,加强对本病的认识和早期发现是改善预后的关键;对于转移或不能切除者,Gleevec是目前最有效的系统治疗方法。
Objective To investigate the clinical, pathological features and prognosis of gastrointestinal stromal tumors (GISTs). Methods The clinical and pathological data of 136 gastrointestinal stromal tumors in our hospital from January 2000 to February 2004 were retrospectively analyzed and followed up. Results GIST mainly occurred in the stomach (57.1%) and the small intestine (20.6%), with relatively less colon, rectum and other sites in the abdominal cavity. The common clinical symptoms were gastrointestinal bleeding (32.4%), abdominal pain (25.0%), abdominal mass 21.3%). At the time of treatment, 17 cases had metastasized and the remaining 119 cases received radical resection or partial resection. The surgical resection rate was 87.5% (119/136). Postoperative recurrence rate of 20.3% (15/74). Conclusion The clinical manifestations of GIST are nonspecific and difficult to diagnose before surgery. Surgical resection is the preferred treatment for patients without metastasis, but the recurrence rate of postoperative metastasis is high. It is the key to improve the prognosis that the awareness and early detection of this disease are strengthened. Gleevec is by far the most effective systemic treatment available for metastasis or unresectability.