中华普外科手术学杂志（电子版）
中華普外科手術學雜誌（電子版）
중화보외과수술학잡지（전자판）
CHINESE JOURNAL OF OPERATIVE PROCEDURES OF GENERAL SURGERY(ELECTRONIC VERSION)
2015年
4期
276-279
,共4页
胃肠道间质肿瘤%免疫组织化学%诊断
胃腸道間質腫瘤%免疫組織化學%診斷
위장도간질종류%면역조직화학%진단
Gastrointestinal stroaml tumors%Immunohistochemistry%Diagnosis
目的：探讨胃肠间质瘤的临床诊断及治疗特点。方法回顾性分析21例胃肠间质瘤患者的临床资料和治疗方法，辅助检查诊断为GIST的方法有：胃镜、肠镜检查及活检组织病理诊断18例（85．7％），增强 CT 检查12例（57．1％），超声内镜检查8例（38．1％），上消化道造影1例（4．8％）。21例患者均行手术治疗，采用SPSS13．0统计软件进行数据分析，术后免疫组织化学及危险度分级分析比较采用χ2检验， P＜0．05被认为有统计学意义。结果21例中15例为胃间质瘤，6例为小肠间质瘤。本组患者进行CD117、CD34、S100、和SMA等4项免疫组织化学检测，表达阳性率CD117（95．24％）和CD34（71．43％），CD117，CD34在胃肠间质瘤中表达明显高于S100（9．52％）和SMA（38．09％），χ2＝10．00、16．13， P＜0．05，差异有统计学意义。中、高危患者口服伊马替尼明显提高生存率。结论 CD117与CD34同时表达有助于临床诊断。手术是胃肠间质瘤的主要治疗方法，靶向药物具有延缓胃肠间质瘤的复发和转移的临床意义。
目的：探討胃腸間質瘤的臨床診斷及治療特點。方法迴顧性分析21例胃腸間質瘤患者的臨床資料和治療方法，輔助檢查診斷為GIST的方法有：胃鏡、腸鏡檢查及活檢組織病理診斷18例（85．7％），增彊 CT 檢查12例（57．1％），超聲內鏡檢查8例（38．1％），上消化道造影1例（4．8％）。21例患者均行手術治療，採用SPSS13．0統計軟件進行數據分析，術後免疫組織化學及危險度分級分析比較採用χ2檢驗， P＜0．05被認為有統計學意義。結果21例中15例為胃間質瘤，6例為小腸間質瘤。本組患者進行CD117、CD34、S100、和SMA等4項免疫組織化學檢測，錶達暘性率CD117（95．24％）和CD34（71．43％），CD117，CD34在胃腸間質瘤中錶達明顯高于S100（9．52％）和SMA（38．09％），χ2＝10．00、16．13， P＜0．05，差異有統計學意義。中、高危患者口服伊馬替尼明顯提高生存率。結論 CD117與CD34同時錶達有助于臨床診斷。手術是胃腸間質瘤的主要治療方法，靶嚮藥物具有延緩胃腸間質瘤的複髮和轉移的臨床意義。
목적：탐토위장간질류적림상진단급치료특점。방법회고성분석21례위장간질류환자적림상자료화치료방법，보조검사진단위GIST적방법유：위경、장경검사급활검조직병리진단18례（85．7％），증강 CT 검사12례（57．1％），초성내경검사8례（38．1％），상소화도조영1례（4．8％）。21례환자균행수술치료，채용SPSS13．0통계연건진행수거분석，술후면역조직화학급위험도분급분석비교채용χ2검험， P＜0．05피인위유통계학의의。결과21례중15례위위간질류，6례위소장간질류。본조환자진행CD117、CD34、S100、화SMA등4항면역조직화학검측，표체양성솔CD117（95．24％）화CD34（71．43％），CD117，CD34재위장간질류중표체명현고우S100（9．52％）화SMA（38．09％），χ2＝10．00、16．13， P＜0．05，차이유통계학의의。중、고위환자구복이마체니명현제고생존솔。결론 CD117여CD34동시표체유조우림상진단。수술시위장간질류적주요치료방법，파향약물구유연완위장간질류적복발화전이적림상의의。
Objective To investigate the clinical characteristics of diagnosis and therapeutic strategies of gastrointestinal stromal tumors ( GISTs ) . Methods Clinical data of 21 patients with GISTs were retrospectively analyzed, including their clinical manifestations , diagnosis and treatment .The auxiliary diagnosis methods of GIST were employed , including gastroscopy , colonoscopy and biopsy tissue pathological diagnosis in 18 patients (85.7%), and enhanced CT examination in 12 patients (57.1%), endoscopic ultrasonography examination in 8 patients (38.1%), and upper gastrointestinal angiography in 1 patient (4.8%).All patients underwent surgery and the final diagnosis was based on postoperative pathology and immunohistochemistry .Clinical data were analyzed by using statistical software SPSS 13.0, the risk of postoperative immunohistochemical and hierarchical analysis by the Chi-square test.A P value <0.05 was considered statistically significant . Results Among the 21 patients, 15 had gastric stromal tumors , and 6 had small intestinal stromal tumors CD 117, CD34, S100, and SMA were detected by immunohistochemistry in all 21 patients.The positive expression rates were 95.24%in CD117 and71.43%in CD34 in gastrointestinal stromal tumors, which were significantly higher than 9.52%in S100 and 38.09%in SMA respectively (χ2 =10.00, 16.13, P<0.05).The patients with intermediate risk and high risk were treated with imatinib , and their survival rate was significantly improved . Conclusions The simultaneous expressions of CD117 and CD34 are helpful to the clinical diagnosis of stromal stumor .Surgery is the main treatment for GIST , and target drugs for the recurrence and metastasis of the tumor are of clinical significance .
