胃肠道间质瘤的临床特征及治疗进展

Small intestinal stromal tumors: Clinical features and factors related to misdiagnosis

AIM

To analyze the clinical characteristics of small intestinal stromal tumors (SISTs) and identify factors related to their misdiagnosis.

METHODS

Clinical data of 104 patients with pathologically proved SISTs were retrospectively analyzed at our hospital from January 2010 to January 2015, with regard to clinical features, tumor location, tumor size, diagnostic methods, and risk classification.

RESULTS

Common clinical symptoms included abdominal mass (67/104, 64.5%), gastrointestinal bleeding (47/104, 52.8%), and abdominal pain (47/104, 52.8%). The lesions were seen mainly in the jejunum (45.2%), followed by the ileum (29.8%) and duodenum (25%). The misdiagnosis rate was as high as 34.6%, and SISTs were often misdiagnosed as gynecological tumors (15/36), digestive tract leiomyomas (6/36) and other diseases. The misdiagnosis was related, to a certain extent, to clinical manifestations, tumor location, tumor size, growth mode, examination methods and other factors, but had nothing to do with sex, age of onset, risk classification, or metastasis.

CONCLUSION

SISTs frequently occur in the jejunum, with gastrointestinal bleeding and abdominal mass being common clinical manifestations. Its clinical misdiagnosis rate is high. Therefore, for patients with recurrent gastrointestinal bleeding and abdominal mass that cannot be clearly diagnosed by color Doppler ultrasound, CT and digestive endoscopy, timely surgical biopsy and immunohistochemistry examination should be performed to achieve early diagnosis and avoid misdiagnosis.

Diagnosis and treatment of duodenal gastrointestinal stromal tumors

Duodenal gastrointestinal stromal tumors are common primary tumors of the duodenum, which are regarded as a group of gastrointestinal stromal tumors in most studies. However, since the duodenum has a special anatomical position and is adjacent to important organs, the diagnosis and treatment of duodenal gastrointestinal stromal tumors have a certain particularity. This paper discusses the special aspects of the diagnosis and treatment of duodenal gastrointestinal stromal tumors, especially the selection of right means of operation based on the tumor condition and the use of effective targeted therapy to achieve good outcome.