小肠间质瘤26例诊治分析

小肠间质瘤26例诊治分析

王墨飞李永双 杨大业 李晓霞

中国医科大学附属第四医院胃肠外科（辽宁 沈阳 110032）

【摘要】 目的：探讨小肠间质瘤的临床表现，诊断及治疗。方法：对1998年9月至2008年9月收治的26例小肠间质瘤的临床资料进行回顾性分析，所有病例均经手术和病理证实。结果：发病年龄34～79（平均52±3.4）岁，消化道出血、腹部包块、脐周隐痛及贫血为最常见的临床表现；B超，增强螺旋CT及数字减影血管造影（DSA）对小肠间质瘤检出率较高；小肠间质瘤手术切除23例，肿瘤无法切除行保守治疗3例；随访2个月至10年（平均60.8±4.6个月），随访率为84.6﹪(22/26)，1，3，5年无病生存率分别为92.1%, 62.8%，54.7%，1，3，5年总体生存率96.2%, 71.0%, 64.5%。结论：小肠间质瘤临床表现缺乏特异性；合理应用辅助检查方法可提高小肠间质瘤检出率；手术为本病目前的最佳选择；格列卫（甲磺酸伊马替尼）对晚期小肠间质瘤有较好疗效。

【关键词】小肠肿瘤·诊断·治疗·预后

【中图分类号】R736.1

【文献标识码】A

Analysis of 26 cases of stromal tumor of small intestine

Wang Mofei，Zhang Jiakui，Yang Daye，Li Xiaoxia．Department of Gastrointestinal Surgery，The 4th Affiliated Hospital of China Medical University．Shenyang，110032，China.Corresponding author：WANG Mofei，Email:murphydoctor@sina.com

【Abstract】 Objective To explore the clinical characteristics、diagnosis and therapeutic of stromal tumor of small intestinel．Methods Clinical data of 26 cases with postoperative pathologic diagnosis from May 1998 to May 2008 were retrospectively reviewed．Results The age of the patients ranged from 34 to 79(average 52±3.4 )years．The major clinical signs included gastrointestinal bleeding，abdominal mass，Vague pain over the umbilical region and anemia．The detection rates by enhanced spiral CT，digital subtraction angiography(DSA) were much higher，Laparoscopic or open small bowel resection was carried out in 23 cases，and irresectable tumor was treated by imatinib mesylate in 3 cases ；The follow-up period ranged from 6 to 120 months (average 60.8±4.6 months)，follow-up rate was 84．6﹪ (23/26)．The 1-,3-,and 5-year disease-free survival (DFS) and overall survival (OS) rates were 92.1%, 62.8%,and 54.7%， and 96.2%, 71.0%,and 64.5%，respectively．Conclusion The clinical manifestations of stromal tumor of small intestine are nonspecific，The detection rate can be improved by rational auxiliary examinaton，The most effective therapy is operation removal，Imatinib mesylate has satisfactory pathiative effect on late staged patients．

【Key words】 Intestinal neoplasms·Diagnosis·Treatment·Prognosis