| 李玥,方海明,胡祥鹏,等.28例小肠间质瘤临床病理特征分析[J].安徽医药,2017,21(8):1399-1401. |
| 28例小肠间质瘤临床病理特征分析 |
| The analysis of clinical pathological featuresand diagnosis of small intestinal stromal tumor:a review of 28 cases |
| 投稿时间：2016-11-26 |
| DOI： |
| 中文关键词: 小肠间质瘤 临床病理特征 诊断 CT B超 |
| 英文关键词: Small intestinal stromal tumors Clinical pathological features Diagnosis CT B-type ultrasound 出现消化道出血,腹部包块,腹部不适,消瘦,贫血等症状时,需考虑到SIST,应及早行剖腹探查,以免延误治疗。参考文献: |
| 基金项目:安徽省自然科学基金(1408085MH178) |
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| 中文摘要: |
| 目的 探讨小肠间质瘤(SIST)临床病理特征,以期指导SIST的早期诊断及预后判断。方法 回顾性分析经普外科及术后病理确诊的SIST病人的一般资料、影像学特征、术后病理等临床资料,依据胃肠间质瘤(GIST)恶性潜能分级标准(改良的NIH标准)进行危险度分级。采用 χ2 检验(Fisher确切概率法)比较高度危险组与中低度危险组临床特征之间的差异。结果 共28例SIST入选,男性占60.7%(17/28),女性占39.3%(11/28),平均年龄(50.8±14.9)岁,SIST临床症状缺乏特异性,首发症状有:体检发现腹部包块7例,消化道出血7例,慢性腹痛9例,急性腹痛5例,以空肠、十二指肠、回肠多见。16例高度危险性(57.1%),12例中低度危险性(42.9%),高危组急性腹痛比例明显高于中低危组(P<0.05),中低度危险组出现消化道出血比例明显高于高度危险组(P<0.05),两组年龄、性别、慢性腹痛、腹部包块的比较差异无统计学意义。B超检查对SIST的检出率不高,CT检出率高于B超。高危组CT检出率明显高于中低危组。结论 SIST首发症状以腹部包块、消化道出血、慢性腹痛多见,高度危险性多见,不同恶性程度SIST临床特征及影像学表现存在差异。CT检出率及诊断符合率明显高于B超,SIST首选手术切除,疑诊SIST应及早手术探查。 |
| 英文摘要: |
| Objective To investigate the clinical pathological features,diagnosis and treatment of small intestinal stromal tumors(SIST). Methods A retrospective analysis of clinical data of patients with SIST which were confirmed by surgery and postoperative pathology that was performed from Jan.2011 to Jan.2016.Risk was assessed according to the GIST of malignant potential classification standard(improved NIH dangerous grading standard).Chi-square test(Fisher′s exact probability method) was used to analysis the difference of clinical features between high risk and moderate-low risk group of SIST. Results Total 28 cases were enrolled,male was 60.7%(17/28),female was 39.3%(11/28),the mean age was 50.8±14.9 years.The clinical manifestations of SIST were non-specific,initial symptom as follows:abdominal masses found by physical examination was 7 cases,gastrointestinal bleeding was 7 cases,chronic abdominal pain was 9 cases,acute abdominal pain was 5 cases.The most common predilection sites of SIST were jejunum,duodenum and ileum,respectively.16 cases were high risk SIST(57.1%),and 12 cases were moderate-low risk SIST(42.9%).The incidence of acute abdominal pain in high-risk group was obviously higher than that in low and medium risk group,while gastrointestinal bleeding more commonly in low and medium risk group(P<0.05).There were no statistically significant differences in age,gender,chronic abdominal pain,abdominal mass between two groups.Spiral abdominal CT in diagnosis rate marked higher than that of B-type ultrasound.Spiral CT detection rate and diagnosis rate for high-risk group was obviously higher than that for middle or lower risk SIST. Conclusion The clinical manifestations of SIST are non-specific,the starting symptoms may be as follow:abdominal mass,gastrointestinal bleeding,chronic abdominal pain,and its early diagnosis is difficult.However,there are differences between clinical symptoms,signs and the characteristics of abdominal imaging in different degree of malignant SIST,spiral abdominal CT scan hasmore higher value in diagnosis of SIST than that of B-type ultrasound.SIST preferred surgical resection,when SIST was suspected,early surgical exploration should be done. |
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