关键词：胃肿瘤；平滑肌肉瘤；诊断；治疗
【摘要】目的总结我院治疗胃平滑肌肉瘤(GLS)的临床经验，以提高对本病的认识和疗效。方法回顾性分析本院33年来收治的GLS21例的临床资料，生存过程描述采用KaplanMeier生存曲线法。结果本组GLS以上腹胀痛不适、上消化道出血及腹部肿块为主要临床表现，其中以上消化道出血尤为突出。本组肿瘤全切除的12例患者5年、10年生存率为67%和50%，肿瘤不全切除的8例患者仅2例生存了5年，10年生存率为0，本组总的5年、10年生存率为47%和37%。结论GLS是胃部常见非上皮性恶性肿瘤，但临床极易误诊，故应提高警惕，综合分析，才能提高本病的诊断率。为了提高生存率和生存质量，对原发肿瘤主张肿瘤全切除，对术后的复发灶和转移灶，主张积极的再切除，但不主张行扩大的淋巴结清除术。
Diagnosis and treatment of gastricleiomyosarcoma
ZHAN Youqing, LI Wei, XU Li, et al
(Department of Abdominal Surgery, Tumor Hospital, Sun Yat sen University of MedicalSciences, Guangzhou 510060, China)
【Abstract】 Objective To summarize the experience ofsurgical treatment of gastric leiomyosarcoma(GLS) , in order to gain more knowledge of GLSand to increase the level of diagnosis and treatment.Methods Clinical and pathologic datafrom 21 patients with GLS treated from 1964 to 1997 were reviewed and analyzed. Thesurvival rate was described by Kaplan Meier method.Results The most common signs andsymptoms were abdominal pain (76% ), gastric bleeding (57% ), and abdominal mass (52%). Among these, the presentation of gastric bleeding was prominent. In this series, twelvepatients were treated by complete tumor excision, the 5 ,10 year survival rate was67% and 50% ; eight patients were treated by partial excision, and only 2 casessurvived for 5 years, the 10 year survival rate was zero; and the overall 5 ,10year survival rate was 47% and 37% .Conclusions GLS is common unepithelial malignanttumor of stomach and easily misdiagnosed. In order to increase its diagnosis rate, thecaution for GLS should be kept, and the comprehension should be applied. To improve thesurvival rate and quality of life, the primary tumor should be excised completely,postoperative recurrent lesion and metastatic lesion should be re excised actively, butthe extended lymph dissection is not recommended.
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