【摘要】 目的:探讨小肠间质瘤(stro-mal tumor of small intestine,SIST)的临床表现、病理特征及诊疗措施。方法:对1994-06-01-2006-06-30收治的47例SIST病例的临床资料进行回顾性分析。结果:本组病例表现为消化道出血38例,腹部疼痛或腹胀5例,腹部包块3例,肠梗阻1例。病理检查:良性18例(38.3%),交界性14例(29.8%),恶性15例(31.9%);肿瘤细胞由梭形细胞构成17例,上皮样细胞构成11例,多形细胞构成19例。本组患者均行手术治疗,手术切除不全(2例)、术后复发(5例)或远处转移(2例)的患者应用甲磺酸依马替尼(格列卫)辅助治疗。随访6个月~9年,5例患者死亡;11例患者术后复发及4例患者术后出现肝转移,7例服用格列卫治疗部分缓解;余27例健在,临床疗效满意。结论:SIST临床表现为消化道出血、腹部疼痛或腹部包块;对长期不明原因的消化道出血患者应及早行剖腹探查或腹腔镜腹腔探查明确诊断进行手术治疗;格列卫辅助治疗手术切除不全或术后复发的SIST具有较好的临床疗效。更多还原

【Abstract】 OBJECTIVE:To summarize the clinical manifestations,pathological features,measurement of diagnosis and treatment for stromal tumor of small intestine(SIST).METHODS:Forty-seven patients with SIST were retrospectively reviewed from 01.1994 to 01.2006.RESULTS:The clinical manifestations of these patients were digestive duct hemorrhage in 38 cases,stomachache or abdominal distension in 5 cases,abdominal mass in 3 cases,and intestinal obstruction in 1 cases.Pathological examination proved that benign stromal tumor was in 18 cases(38.3%),potential malignant types in 14 cases(29.8%),and malignant types in 15 cases(31.9%).The tumor cell types were spindle cell type in 17 cases,epithelial cell type in 11 cases,and polymorphous cell types in 19 cases.All the patients were managed by surgical operation,and those patients whose tumor could not be cut completely(2 cases),recurrence(5 cases) or metastasis(2 cases) were managed by imatinib mesylate.During the follow up period from 6 mouths to 9 years,except 5 cases being died,7 patients were treated by oral administration of imatinib mesylate(Gleevec),and there were 15 patients whose SISTs were recurrence or metastasis post-operation,and 27 patients survived today and their SIST did not recurre.CONCLUSIONS:SIST presents for digestive duct hemorrhage,stomachache and abdominal inflation or abdominal mass.Exploratory laparotomy or laparoscopic laparotomy is the first diagnosis choice for the patients suspicious SIST.Imatinib mesylate has rather better clinical effect for those patients with SIST not being able to be excised completely and metastasis or recurrence post operation.更多还原