CD117弱表达及阴性表达的胃肠道间质瘤13例分析

  目的 分析 CD117弱表达及阴性表达的胃肠道间质瘤的特点。方法 回顾性分析 13 例经手术病理证实的 CD117弱表达及阴性表达胃肠道间质瘤的特点。结果　肿瘤位于胃部 6 例，小肠 4 例，结直肠 2 例，大网膜 1 例。腹部疼痛不适 6 例，呕血或黑便 3 例。病理学检查肿瘤为良性者 5 例，恶性者8 例。CT 检查表现为软组织密度，5例病变含有囊变及出血，所有病变均未见钙化。良性肿瘤大小（最长径×最短径）平均为3.4 cm×2.8 cm；恶性肿瘤大小平均为7.5 cm×6.2 cm。13 例患者均经手术治疗，手术切除率100 ％。10 例术后获随访6个月~ 4 年，有1 例死于肿瘤复发转移，其余至今仍生存。结论　CD117弱表达及阴性表达的胃肠道间质瘤的好发部位为胃体。CT 扫描有助于 CD117弱表达及阴性表达胃肠道间质瘤的定位和良恶性的判断。手术是其治疗的主要方法。

Clinical analysis of the CD117-weak and CD117-negative gastrointestinal stromal tumors: a report of 13 cases

Objective To explore the CT features in CD117-weak and CD117-negative gastrointestinal stromal tumors (GIST). Methods The CD117-weak and CD117-negative Gist proved by pathologically and sur－gically in 13 cases were retrospectively analyzed. Results The tumor was located in the stomach in 6 cases, small intestine in 4 cases, colorectum in 2 cases, greater omentum in one case. The most common clinical manifestations were abdominal pain or discomfort in 6 cases, hematemesis or melena in 3 cases. Malignant tu－mors occurred in 8 cases. Benign tumors occurred in 5 cases. A soft tissue was identified in all 13 cases in CT examination. The CT examinations revealed cystic regions and bleeding in 5 cases. Calcification was not noted within the masses in all cases. The mean diameter of benign tumors was 3.4 cm ×2.8 cm while that of malig－nant tumor was 7.5 cm×6.2 cm. All the cases underwent operation, the resection rate was 100 %. After follow up from 6 months to 4 years in 10 cases, 1 case died of tumor recurrence and metastasis, the others survived. Conclusion CD117-weak and CD117-negative Gist occurred more common in the stomach. CT is useful in lo－cation and differentiation of CD117-weak and CD117-negative gastric stromal tumors with regard to benign or malignant. Surgery is the main method for final diagnosis and treatment.