8 例胃神经鞘瘤的临床诊治分析_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

李忠生 ^1,2 , 李星龙 ^1,2 ,  李国东 ^1,2 , 于晓彤 ^1,2 , 党树伟 ^1,2 , 张淑君 ³ , 毕丹丹 ³

1. ;
2. ;
3. ;

Corresponding author：

李国东, Email: jonathanlgd@163.com

Keywords：

胃神经鞘瘤; 临床诊断; 治疗

DOI：

10.7507/1007-9424.201810056

Video：

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目的分析胃神经鞘瘤（gastric schwannoma，GS）的临床及病理特征并总结其诊断和治疗方法。方法回顾性分析哈尔滨医科大学附属第四医院普外科于 2013–2017 年期间收治的 8 例 GS 患者的临床病例资料，包括一般资料、临床表现、诊断方法、治疗手段等。结果 8 例患者均进行手术治疗，其中 4 例行腹腔镜胃肿瘤切除，3 例行开腹胃肿物切除，1 例采用腹腔镜、胃镜双镜联合胃肿物切除。对患者术后随访 2～50 个月，8 例患者均未复发。GS 镜下的梭形细胞和“淋巴细胞套”是其最显著特点。免疫组织化学染色 S-100 呈弥漫性阳性。结论 GS 是一种发生于胃黏膜下的肿瘤，多为良性，其临床表现不典型，主要可表现为腹痛和腹胀，胃镜和 CT 检查难以确诊该病，免疫组织化学检查结果是目前诊断该病的金标准，手术切除是有效的治疗方法。

Citation： 李忠生, 李星龙, 李国东, 于晓彤, 党树伟, 张淑君, 毕丹丹. 8 例胃神经鞘瘤的临床诊治分析. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(4): 476-479. doi: 10.7507/1007-9424.201810056 Copy

1.	Vargas Flores E, Bevia Pérez F, Ramirez Mendoza P, et al. Laparoscopic resection of a gastric schwannoma: A case report. Int J Surg Case Rep, 2016, 28: 335-339.
2.	朱音, 李昌水, 郑江江, 等. 胃神经鞘瘤 5 例临床病理分析. 现代实用医学, 2015, 27(10): 1368-1370.
3.	Yoon HY, Kim CB, Lee YH, et al. Gastric schwannoma. Yonsei Med J, 2008, 49(6): 1052-1054.
4.	Ohno T, Ogata K, Kogure N, et al. Gastric schwannomas show an obviously increased fluorodeoxyglucose uptake in positron emission tomography: report of two cases. Surg Today, 2011, 41(8): 1133-1137.
5.	胡宝光. 胃神经鞘瘤的研究现状. 消化肿瘤杂志 (电子版), 2015, 7(3): 133-135.
6.	Ji JS, Lu CY, Mao WB, et al. Gastric schwannoma: CT findings and clinicopathologic correlation. Abdom Imaging, 2015, 40(5): 1164-1169.
7.	Tao K, Chang W, Zhao E, et al. Clinicopathologic features of gastric schwannoma: 8-year experience at a single institution in China. Medicine (Baltimore), 2015, 94(45): e1970.
8.	邱云峰, 杜琪威, 杨维良. 胃神经鞘瘤的临床特点及诊治 (附 21 例报告). 腹部外科, 2015, 28(1): 44-46, 49.
9.	Watanabe A, Ojima H, Suzuki S, et al. An individual with gastric schwannoma with pathologically malignant potential surviving two years after laparoscopy-assisted partial gastrectomy. Case Rep Gastroenterol, 2011, 5(2): 502-507.
10.	邱静, 杨顺清, 梁晓东, 等. 胃间质瘤及神经鞘瘤的临床病理特征及鉴别诊断分析. 临床与实验病理学杂志, 2014, 30(8): 911-914.
11.	Zheng L, Wu X, Kreis ME, et al. Clinicopathological and immunohistochemical characterisation of gastric schwannomas in 29 cases. Gastroenterol Res Pract, 2014, 2014: 202960.
12.	Yoon JM, Kim GH, Park DY, et al. Endosonographic features of gastric schwannoma: a single center experience. Clin Endosc, 2016, 49(6): 548-554.
13.	吴玉珍, 倪萍, 林燕, 等. 胃神经鞘瘤的 MSCT 影像学表现分析. 中国医疗设备, 2014, 29(10): 144-146.
14.	Akazawa Y, Ueyama H, Nagahara A, et al. Case of computed tomography (CT) gastrography for the detection of multiple gastric submucosal tumors: a case report. Nihon Shokakibyo Gakkai Zasshi, 2014, 111(10): 1968-1975.
15.	李忠生, 李国东, 刘明. 胃神经鞘瘤的研究现状. 中国普外基础与临床杂志, 2017, 24(12): 1541-1545.
16.	姜胜东. 胃神经鞘瘤的多层螺旋 CT 诊断价值. 医学影像学杂志, 2013, 23(3): 424-426.
17.	盛卫忠, 刘寒, 纪元, 等. 腹腔镜手术治疗胃间叶源性肿瘤的临床研究. 外科理论与实践, 2012, 17(2): 143-146.
18.	Sreevathsa MR, Pipara G. Gastric schwannoma: a case report and review of literature. Indian J Surg Oncol, 2015, 6(2): 123-126.
19.	孙龙. 胃神经鞘瘤临床病理分析. 中国现代医生, 2015, 53(29): 109-115.
20.	Voltaggio L, Murray R, Lasota J, et al. Gastric schwannoma: a clinicopathologic study of 51 cases and critical review of the literature. Hum Pathol, 2012, 43(5): 650-659.
21.	Williamson JM, Wadley MS, Shepherd NA, et al. Gastric schwannoma: a benign tumour often mistaken clinically, radiologically and histopathologically for a gastrointestinal stromal tumour—a case series. Ann R Coll Surg Engl, 2012, 94(4): 245-249.
22.	Manji M, Ismail A, Komba E. Gastric schwannoma: Case report from Tanzania and brief review of literature. Clin Case Rep, 2015, 3(7): 562-565.
23.	张再重, 王雯, 王烈. 双镜联合技术在结直肠肿瘤中的应用. 中华胃肠外科杂志, 2015, 18(6): 540-543.
24.	彭涛, 娄展, 赵轶峰, 等. 双镜联合治疗胃丛状神经鞘瘤. 中华胃肠外科杂志, 2017, 20(7): 829-830.

1. Vargas Flores E, Bevia Pérez F, Ramirez Mendoza P, et al. Laparoscopic resection of a gastric schwannoma: A case report. Int J Surg Case Rep, 2016, 28: 335-339.
2. 朱音, 李昌水, 郑江江, 等. 胃神经鞘瘤 5 例临床病理分析. 现代实用医学, 2015, 27(10): 1368-1370.
3. Yoon HY, Kim CB, Lee YH, et al. Gastric schwannoma. Yonsei Med J, 2008, 49(6): 1052-1054.
4. Ohno T, Ogata K, Kogure N, et al. Gastric schwannomas show an obviously increased fluorodeoxyglucose uptake in positron emission tomography: report of two cases. Surg Today, 2011, 41(8): 1133-1137.
5. 胡宝光. 胃神经鞘瘤的研究现状. 消化肿瘤杂志 (电子版), 2015, 7(3): 133-135.
6. Ji JS, Lu CY, Mao WB, et al. Gastric schwannoma: CT findings and clinicopathologic correlation. Abdom Imaging, 2015, 40(5): 1164-1169.
7. Tao K, Chang W, Zhao E, et al. Clinicopathologic features of gastric schwannoma: 8-year experience at a single institution in China. Medicine (Baltimore), 2015, 94(45): e1970.
8. 邱云峰, 杜琪威, 杨维良. 胃神经鞘瘤的临床特点及诊治 (附 21 例报告). 腹部外科, 2015, 28(1): 44-46, 49.
9. Watanabe A, Ojima H, Suzuki S, et al. An individual with gastric schwannoma with pathologically malignant potential surviving two years after laparoscopy-assisted partial gastrectomy. Case Rep Gastroenterol, 2011, 5(2): 502-507.
10. 邱静, 杨顺清, 梁晓东, 等. 胃间质瘤及神经鞘瘤的临床病理特征及鉴别诊断分析. 临床与实验病理学杂志, 2014, 30(8): 911-914.
11. Zheng L, Wu X, Kreis ME, et al. Clinicopathological and immunohistochemical characterisation of gastric schwannomas in 29 cases. Gastroenterol Res Pract, 2014, 2014: 202960.
12. Yoon JM, Kim GH, Park DY, et al. Endosonographic features of gastric schwannoma: a single center experience. Clin Endosc, 2016, 49(6): 548-554.
13. 吴玉珍, 倪萍, 林燕, 等. 胃神经鞘瘤的 MSCT 影像学表现分析. 中国医疗设备, 2014, 29(10): 144-146.
14. Akazawa Y, Ueyama H, Nagahara A, et al. Case of computed tomography (CT) gastrography for the detection of multiple gastric submucosal tumors: a case report. Nihon Shokakibyo Gakkai Zasshi, 2014, 111(10): 1968-1975.
15. 李忠生, 李国东, 刘明. 胃神经鞘瘤的研究现状. 中国普外基础与临床杂志, 2017, 24(12): 1541-1545.
16. 姜胜东. 胃神经鞘瘤的多层螺旋 CT 诊断价值. 医学影像学杂志, 2013, 23(3): 424-426.
17. 盛卫忠, 刘寒, 纪元, 等. 腹腔镜手术治疗胃间叶源性肿瘤的临床研究. 外科理论与实践, 2012, 17(2): 143-146.
18. Sreevathsa MR, Pipara G. Gastric schwannoma: a case report and review of literature. Indian J Surg Oncol, 2015, 6(2): 123-126.
19. 孙龙. 胃神经鞘瘤临床病理分析. 中国现代医生, 2015, 53(29): 109-115.
20. Voltaggio L, Murray R, Lasota J, et al. Gastric schwannoma: a clinicopathologic study of 51 cases and critical review of the literature. Hum Pathol, 2012, 43(5): 650-659.
21. Williamson JM, Wadley MS, Shepherd NA, et al. Gastric schwannoma: a benign tumour often mistaken clinically, radiologically and histopathologically for a gastrointestinal stromal tumour—a case series. Ann R Coll Surg Engl, 2012, 94(4): 245-249.
22. Manji M, Ismail A, Komba E. Gastric schwannoma: Case report from Tanzania and brief review of literature. Clin Case Rep, 2015, 3(7): 562-565.
23. 张再重, 王雯, 王烈. 双镜联合技术在结直肠肿瘤中的应用. 中华胃肠外科杂志, 2015, 18(6): 540-543.
24. 彭涛, 娄展, 赵轶峰, 等. 双镜联合治疗胃丛状神经鞘瘤. 中华胃肠外科杂志, 2017, 20(7): 829-830.

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8 例胃神经鞘瘤的临床诊治分析

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