中文摘要：

目的探讨胃肠间质瘤（gastrointestinal stromal tumor,GIST）的临床特点、诊疗方法和预后,进一步提升对此类疾病的认识。方法回顾分析解放军总医院肿瘤外科2009年9月-2014年9月收治的90例GIST患者的完整临床和病理资料。结果最常见的临床表现为腹部胀痛不适、纳差占41.1%（37/90）,其次为消化道出血占20.0%（18/90）,腹部包块占4.4%（4/90）,肠梗阻症状占3.3%（3/90）,28例无明显症状占31.1%,为检查时偶然发现。术前诊断主要依靠胃肠镜、超声内镜、CT、MRI等影像学检查。90例均接受手术治疗。免疫组化CD117阳性率90.0%（81/90）,CD34阳性率91.1%（82/90）,S-100阳性率11.1%（10/90）,SMA阳性率33.3%（30/90）。中位随访时间27.4（1~60）个月,8例复发或转移,3例再次手术,2例因肿瘤进展死亡。单因素分析显示,肿瘤大小（P=0.019）及核分裂数目（P=0.002）是影响预后的因素。结论GIST的临床表现无特异性,胃肠镜、超声内镜、CT、MRI等检查有助于该病术前诊断。确诊主要依靠病理学及免疫组化,外科手术是GIST的首选治疗方式。

英文摘要：

Objective To identify clinical characteristics, diagnosis, treatment and prognosis of gastrointestinal stromal tumor （GIST） and improve the level on standardized diagnosis and treatment of this disease. Methods Clinical and pathological data about 90 patients with GIST in the department of surgical oncology, Chinese PLA General Hospital from September 2009 to September 2014 were retrospectively analyzed. Results The most common primary symptom was abdominal discomfort accounting for 41.1 % （37/90）, followed by gastrointestinal tract hemorrhage for 20.0% （18/90）, abdominal mass for 4A% （4/90）, intestinal obstruction for 3.3% （3/90）, 28 cases with no symptoms accounting for 31.1%. The preoperative imageological examinations comprised endoscope, endoscopic ultrasonography, CT, MRI. 90 patients received complete surgical resection. Immunohistochemistry demonstrated that tumor cells were positive for CDll7 in 81 cases （90.0%）, for CD34 in 82 cases （91.1%）, for S-100 in 10 cases （11.1%） and for SMA in 30 cases （33.3%）. During a mean follow-up period of 27.4 （range, 1-60） months, 8 patients experienced relapse and metastasis, 3 patients underwent re-operation. Two patients died of tumor progression. Univariate analysis revealed that tumor size （P=0.019） and mitotic rate （P=0.002） were factors affecting prognosis. Conclusion GIST shows typical clinical features. Endoscopy, ultrasound endoscope, CT and MRI examination are helpful for preoperative diagnosis of this disease. The confirmation of GIST also require histopathologic examination and immunohistochemistry. Surgery treatment is the first choice for GIST.