CAJ | 학술논문

目的：提高对前列腺部位胃肠外间质瘤(EGISTs)病因、临床特点、诊断及治疗的认识。方法我院2010年至2014年收治4例发生于前列腺部位的 EGISTs 患者，术前诊断为前列腺肿瘤、直肠肿物，均行盆腔肿物切除术。报告其中1例临床资料，并行文献复习。结果患者因排便困难伴血便3月入院，直肠指诊发现直肠前壁黏膜下有一质韧肿物，考虑为直肠肿物。盆腔的 B 超及 MRI检查均提示肿物可能来源于前列腺。盆腔肿物探查术后病理结果提示为(前列腺)间叶组织肿瘤，梭形细胞为主，增生活跃，诊断为恶性 EGISTs；免疫组化检查 CD117、CD34均阳性。结论前列腺部位 EGISTs 发病与 C-kit 和 PDGFRA 基因状态有着密切联系，临床表现有会阴部酸疼不适、尿频、尿急、排尿困难、肉眼血尿、排便困难、血便，术前确诊需结合影像学检查和肿瘤穿刺病理免疫组化检测，治疗以手术为主，无手术适应证的患者可行药物辅助靶向治疗。
목적：제고대전렬선부위위장외간질류(EGISTs)병인、림상특점、진단급치료적인식。방법아원2010년지2014년수치4례발생우전렬선부위적 EGISTs 환자，술전진단위전렬선종류、직장종물，균행분강종물절제술。보고기중1례림상자료，병행문헌복습。결과환자인배편곤난반혈편3월입원，직장지진발현직장전벽점막하유일질인종물，고필위직장종물。분강적 B 초급 MRI검사균제시종물가능래원우전렬선。분강종물탐사술후병리결과제시위(전렬선)간협조직종류，사형세포위주，증생활약，진단위악성 EGISTs；면역조화검사 CD117、CD34균양성。결론전렬선부위 EGISTs 발병여 C-kit 화 PDGFRA 기인상태유착밀절련계，림상표현유회음부산동불괄、뇨빈、뇨급、배뇨곤난、육안혈뇨、배편곤난、혈편，술전학진수결합영상학검사화종류천자병리면역조화검측，치료이수술위주，무수술괄응증적환자가행약물보조파향치료。
Objective To improve the understanding of the etiology,clinical characteristics,diag-nosis and treatment of extra-gastrointestinal stromal tumors of the prostate.Methods Four ca-ses of EGISTs of the prostate were reported and the related literatures were reviewed.Results The patient’s clinical symptoms included difficult defecation and bloody stool.One strong but pli-able tumor was found under mucosa of posterior wall of rectum by digital rectal examination, which was identified as rectal neoplasms.B-ultrasonic examination and MRI of the pelvic sugges-ted that the tumor probably was derived from the prostate.The postoperative pathological results showed mesenchymal tissue tumor from the prostate.Immunohistochemical findings revealed that the neoplastic cells were positive for CD34 and CD1 17.Conclusion Primary extra-gastroin-testinal stromal tumor of the prostate has intimate connection with the status of C-kit and PDG-FRA.Its clinical features may include perineal pain,frequent urination,urgency,macroscopic hematuria,difficult defecation and bloody stool.Preoperative diagnosis should be combined with imaging examination and biopsy in immunohistochemical detection.Surgeries are the main mode of treatment.Therapy targeting of tyrosine protein kinase should be used for the unresectable ca-ses.