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1、258岭南现代临床外科2005年12月第5卷第4期LingnanModernClinicsinSurgery,Dec.2005,Vol.5No.446例胃肠道间质瘤的临床诊治分析陈图锋1卫洪波1崔冀2广州市中山大学附属第三医院胃肠外科1(510630);广州市中山大学附属第一医院胃肠外科2(510089)!摘要"目的探讨胃肠道间质细胞瘤的诊断和治疗。方法回顾性分析1997年1月至2005年1月收治的46例胃肠道间质细胞瘤的临床资料。结果本组46例均行手术治疗,无手术中死亡病例。术后在切口感染及其它严重并发症。术后获得随访42例。其中良性及交界性GIST获得随访26例(26
2、/28),平均随访30个月,为无瘤生存。恶性GIST获得随访15例,平均随访21个月。其中7例为无瘤生存,2例分别于术后第10及21个月发生肝多发性转移,1例术后20个月发生全身骨转移,3例分别于术后第6、9及11个月死于多发性远处转移。结论GIST由于缺乏特异的临床表现,影像学及内镜检查往往在术前亦难以作出定性诊断,但B超内镜引导下细针穿刺活检及免疫组化检查对诊断比较可靠。手术治疗效果良好。手术治疗的原则是:良性及交界性GIST以局部切除为主,恶生GIST宜行较大范围的手术,必要时须行联合脏器切除术。!关键词"胃肠道间质瘤中图分类号#R735.2文献标识码#A文章编号#
3、1009-976X$2005%04-0258-03!"#$%&’"’(%)*+,(*-,%*&.$(’*+&"%*,’*"%(/’*+&-(/*0-&+’(1%(/2’"’&.345(’,’)CHENTu-feng,WEIHong-bo,CUIJi.DepartmentofeneralSurgery,TheThirdAffiliatedHospital,SunYat_SenUniversity,uangzhou>?@AB@(16’*+(5*)768,5*"9,Tostudythediagnosisandtreatmentforgastrointestinalstromal
4、tumors(GIST).:,*;&)’FromJanuary1997toApril2005,46caseswithgastrointestinalstromaltumorswereanalyzedretrospectively.<,’0/*’Theoperativetreatmentwasperformedinallcases.Nointraoperativedeath,nopostoperativewoundinfectionandotherseverecomplicationswerefound.Postoperativefollow-upwasgottenin42
5、cases.Amongthem,benignandjunctionalGISTwerefollowed-upin26cases(26/28).Averagefollow-upwas21monthsandnotumorsurvivorshipwasinallcases.MalignantGISTwasfollow-upin15casesandaveragefollow-upwas21months.Amongththem,notumorsurvivorshipwasin7cases.Multiplehepaticmetastaseswereoccuredin2cases10t
6、hthand21monthafteroperationrespectively.Generalbonemetastaseswerehappenedin1case20monthafteroperation.2caseswererelapseintheomentumandneighborperitoneumandreoperationthwasperformed.3casesdiedfromremotemetastases6,9and11monthafteroperationrespectively.=&%5/0’"&%BecauseofGISTlacksofspecific
7、clinicalmanifestation,thequalitativediagnosisisdifficultlymadebytheimagingandendoscopybeforeoperation.Butusingfineneedlebiopsyofultrasonicendoscopeguided,thediagnosisofGISTismorereliable.Effectofoperativetreatmentisbetter.Theprinciplesofoperativetreatmentareasfollow
