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目的探讨胃间质瘤的诊治方法。方法回顾性分析手术治疗的胃间质瘤16例患者的临床资料,包括肿瘤生长的部位、方式、诊断方法、病理、治疗方式及结果。结果肿瘤位于胃体部10例,胃窦部4例,胃底部2例。胃镜诊断率54%,钡餐诊断率75%,B超诊断率69%,CT诊断率75%,MRI诊断率80%。行胃次全切除术8例;局部切除术3例;全胃切除术5例(其中联合脏器切除术2例)。病理诊断:恶性11例,良性3例,潜在恶性2例。全组无手术死亡。13例获术后随访0.5～5年,5例术后18个月内死于肿瘤复发;2例术后24个月内死于肿瘤复发、肝转移;余4例存活12个月至5年。服格列卫2例,存活至今已有22个月和36个月。结论多种辅助检查综合诊断,可提高术前的诊断率,免疫组化检查有助于确诊,手术切除是主要治疗手段,中、高危患者术后宜服格列卫。
Objective To investigate the diagnosis and treatment of gastric stromal tumors. Methods The clinical data of 16 patients with gastric stromal tumor undergoing surgery were retrospectively analyzed, including the location, manner, diagnosis, pathology, treatment modalities and results of tumor growth. Results The tumor located in the body of the stomach in 10 cases, 4 cases of gastric antrum and 2 cases of gastric fundus. Gastroscopy diagnostic rate of 54%, barium meal diagnostic rate of 75%, B ultrasound diagnosis rate of 69%, CT diagnostic rate of 75%, MRI diagnostic rate of 80%. Subtotal gastrectomy in 8 cases; 3 cases of partial resection; total gastrectomy in 5 cases (including 2 cases of combined organ resection). Pathological diagnosis: malignant in 11 cases, benign in 3 cases, 2 cases of potential malignancy. The whole group died without surgery. Thirteen patients were followed up for 0.5-5 years. Five patients died of tumor recurrence within 18 months after operation. Two patients died of tumor recurrence and liver metastasis within 24 months after operation. The remaining four patients survived for 12 months to 5 years . 2 cases of Gleevec, survival has been 22 months and 36 months. Conclusions The comprehensive diagnosis of multiple auxiliary examinations can improve the preoperative diagnosis rate. Immunohistochemical examination is helpful for the diagnosis. Surgical resection is the main treatment method. The patients in middle and high risk should be treated with Gleevec after the operation.