目的 探讨小肠间质瘤的临床表现、病理免疫组织化学特征与治疗方法。 方法 回顾性分析2007年1月－2011年7月70例小肠间质瘤患者的临床表现，免疫组织化学特征及治疗手段。 结果 小肠间质瘤患者并无特异性临床表现，主要临床表现包括腹痛、腹胀、血便，腹部包块等。极低风险5例，低风险18例，中风险13例，高风险34例。免疫组织化学显示CD117、DOG1、CD34、S-100、平滑肌肌动蛋白（SMA）、增殖细胞核抗原（Ki-67）、人结蛋白（Desmin）的阳性率分别为95.7%（67/70）、100%（11/11）、51.4%（36/70）、5.7%（4/70）、12.9%（9/70）、60.0% （42/70）、0% （0/70）。治疗上主要以手术完整切除为主，伊马替尼主要用于无法切除，转移或中、高危险度的患者。 结论 小肠间质瘤患者临床表现缺乏特异性表现，发现时往往肿瘤较大、风险度高，选择合理的辅助检查方法可以提高其检出率，目前手术是首选的治疗方式。
目的 探讨胃肠道外间质瘤（EGIST）的临床表现、外科治疗及预后。 方法 回顾性分析2004年1月－2010年6月收治的35例EGIST患者的临床资料。男26例，女9例；年龄33～78岁，平均56岁。病程5 d～8个月，平均2个月。临床表现主要有腹部不适、腹痛及腹部包块等。均在术前行CT或腹部增强CT等检查发现病灶，其中位于系膜16例，网膜15例，腹膜后4例。35例均行手术治疗。 结果 术后均由病理学检查及免疫组织化学检测确诊，肿瘤标本镜下均以梭形细胞为主；极低危险、低危险、中危险、高危险患者分别为0、3、0、32例。免疫组织化学检测示酪氨酸激酶受体（CD117）、DOG-1、骨髓干细胞抗原（CD34）、酸性钙结合蛋白、平滑肌肌动蛋白、结蛋白阳性率分别为91.4%（32/35）、100%（3/3）、71.4%（25/35）、8.6%（3/35）、22.9%（8/35）、0%（0/35）。15例患者均获随访，时间19～96个月，平均46个月。8例出现进展，7例病情稳定。 结论 EGIST发现时往往体积较大，预后较差，手术切除是首选治疗手段，甲磺酸伊马替尼对其具有较好的治疗效果。
Objective To investigate the clinical characteristics， diagnosis， and treatment of gastric stromal tumor. Methods Clinical data of 217 patients with gastric stromal tumor from October 2007 to July 2011 were analyzed. Results The main clinical manifestation were abdominal pain， abdominal distension， bloody stools， abdominal mass， and so on. The tumour located at cardiac part， fundus of stomach， body of stomach， and pylorus part was 24 cases （11.0%）， 103 cases （47.5%）， 59 cases （27.2%）， and 31 cases （14.3%）， respectively. All the 217 patients underwent endoscopic or surgical resection and diagnosed by pathology and immunohistochemistry. The patients of high-low risk， low risk， intermediate risk， and high risk was 56 cases （25.8%）， 67 cases （30.9%）， 41 cases （18.9%）， and 53 cases （24.4%）， respectively. One hundred and forty patients were followed-up for 7-52 months （average 35 months）. Thirty-five patients of high risk were investigated about the drug treatment after the first operation：19 cases were treated by using imatinib （tumor progressed in 2 cases） and 16 patients were not （tumor progressed in 9 patients）. The rate of progression of patients treated by imatinib was significantly lower than another group （χ2=8.426， P=0.004）. In 11 patients with tumor progressed， tumor recurrnce in 4 cases， tumor recurrence with diffused abdominal cavity metastasis in 1 case， tumor metastasized to humerus in 1 case， metastasized to liver and abdominal cavity in 1 case， and metastasized to liver in 4 cases. Conclusions Gastric stormal tumor is lack of specific clinical manifestations. Complete excision of the tumor is the main therapy method， and imatinib can improve prognosis.
ObjectiveTo evaluate the lymphatic tracing effects of nano-carbon particles for radical gastrectomy. MethodsTotally eighty-six cases of gastric cancer patients were randomly divided into experimental group (n=43) and control group (n=43). In the experimental group, nanocarbon was injected into the subserosa around the tumor for lymphatic tracing before operation, while no tracer was given in the control group. Then the number of lymph nodes dissected, operation time, and postoperative complications of patients were compared. ResultsThe number of lymph nodes dissected in patients of experimental group was 30.20±11.63 (17-45), which was significantly more than that of control group 〔22.47±7.60 (15-31)〕, Plt;0.05. The blacken rate of lymph nodes in patients of the experimental group was 74.56% (1 260/1 690). Of 302 metastatic lymph nodes, the blacken rate of metastatic lymph nodes was 61.26% (185/302), which was significantly higher than the nonblacken rate of metastatic lymph nodes (38.74%, 117/302), Plt;0.05. The operation time of patients in experimental group 〔(3.51±0.43) h〕 was not different from that in control group 〔(3.49±0.51) h〕, Pgt;0.05. The postoperative complications of patients in two groups was not different and no local or systemic adverse reaction occurred in patients of experimental group. ConclusionSubserosal injection of nanocarbon particles around the tumor is safe and can provide the guidance to lymph node dissection in radical gastrectomy.