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目的探讨胃间质瘤的手术治疗方法及临床病理特点。方法回顾性分析经手术治疗的78例胃间质瘤患者的临床和病理资料,其中男34例,女44例。手术完全切除76例,其中胃楔形切除39例,远端胃大部切除术17例,近端胃大部切除术20例;姑息性切除2例。结果肿瘤平均直径5.5cm,其中<5cm者39例,5~10cm者27例,>10cm者12例。病变位于胃窦部12例,胃体部30例,胃底部36例。胃周淋巴结转移2例(2.6%)。免疫组化结果:CD117阳性74例(94.9%),CD34阳性61例(78.2%),SMA阳性29例(37.2%),Desmin阳性8例(10.3%),S-100阳性8例(10.3%)。72例(92.3%)获随访,平均56.1(3~168)个月,术后5年生存率为70.3%,术后复发转移11例(15.3%),术后复发转移者再次手术治疗6例,再次手术切除可延长患者生命。结论胃间质瘤的治疗以手术为主,术中应注意完整切除和防止肿瘤破裂。
Objective To investigate the surgical treatment of gastric stromal tumors and its clinicopathological features. Methods The clinical and pathological data of 78 patients with gastric stromal tumor treated by surgery were retrospectively analyzed, including 34 males and 44 females. Surgical resection of 76 cases, including wedge resection in 39 cases, distal gastrectomy in 17 cases, 20 cases of proximal gastrectomy; palliative resection in 2 cases. Results The average diameter of the tumor was 5.5 cm. There were 39 cases <5 cm, 27 cases 5 ~ 10 cm and 12 cases> 10 cm. Lesions located in the antrum in 12 cases, 30 cases of gastric body, stomach at the bottom of 36 cases. Peritoneal lymph node metastasis in 2 cases (2.6%). Immunohistochemical results showed that there were 74 (94.9%) positive for CD117, 61 (78.2%) positive for CD34, 29 (37.2%) positive for SMA, 8 (10.3%) Desmin positive and 8 (10.3% ). 72 patients (92.3%) were followed up for an average of 56.1 (3 ~ 168) months. The 5-year survival rate was 70.3%, and postoperative recurrence and metastasis in 11 patients (15.3% Surgical resection can prolong patient’s life. Conclusion The treatment of gastric stromal tumors mainly surgery, surgery should pay attention to complete resection and prevent tumor rupture.