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| 1 | Rectal gastrointestinal stromal tumors:Imaging features with clinical and pathological correlation显示文摘AIM:To investigate computed tomography(CT) and magnetic resonance imaging(MRI) manifestations of rectal gastrointestinal stromal tumors(GISTs) in order to enhance the recognition of these rare tumors.METHODS:Fourteen patients with pathologically proven rectal GISTs were retrospectively reviewed.Patient histories were retrospectively reviewed for patient age,gender,presenting symptoms,endoscopic investigations,operation notes and pathologic slides.All tumors were evaluated for CD117,CD34 expression,and the tumors were stratified according to current criteria of the National Institutes of Health(NIH).In all cases the first pre-operation imaging findings(CT and MRI,n = 3;MRI only,n = 8;CT only,n = 3) were analyzed by two experienced radiologists by consensus,which include:tumor size,shape,CT density(hypodense,isodense and hyperdense),MRI signal intensity(hypointense,isointense and hyperintense),epicenter(intraluminal or extraluminal),margin(well-defined or ill-defined),internal component(presence of calcifications,necrosis,hemorrhage or ulceration),pattern and degree of enhancement,invasion into adjacent structures.After review of the radiologic studies,clinical and pathological findings were correlated with radiological findings.RESULTS:The patients,13 men and 1 woman,were aged 31-62 years(mean = 51.5 ± 10.7 years).The most common initial presentation was hematochezia(n = 6).The mean tumor diameter was 5.68 ± 2.64 cm(range 1.5-11.2 cm).Eight lesions were round or oval,and 6 lesions were irregular.Eleven lesions were welldefined and 3 had ill-defined margins.Ten tumors were extraluminal and 4 were intraluminal.The density and MR signal intensity of the solid component of the lesions were similar to that of muscle on unenhanced CT(n = 6) and T1-weighted images(n = 11),and hyperintense on T2-weighted MR images.Calcification was detected in 2 tumors.Following intravenous injection of contrast media,3 lesions had mild enhancement and 11 lesions had moderate enhancement.Enhancement was homogenous in 3 lesions and heterogeneous in 11.In 1 of 11 patients who underwent both CT and MRI,the tumor was homogenous on CT scan and heterogeneous on MRI.Eight patients were classified as high risk according to the modified recurrent risk classification system of NIH.CONCLUSION:Rectal GISTs usually manifest as large,well-circumscribed,exophytic masses with moderate and heterogeneous enhancement on CT and MRI.The invasion of adjacent organs,bowel obstruction and local adenopathy are uncommon. | Zhao-Xia Jiang Sheng-Jian Zhang Wei-Jun Peng Bao-Hua Yu | 2013 | World Journal of Gastroenterology2013，19，20： | 31 |
| 2 | 直肠胃肠间质瘤不同手术入路的探索:从TME到TEM再到TaTME显示文摘直肠胃肠间质瘤(gastrointestinal stromal tumor,GIST)相对罕见,约占全部GIST的5%,约占直肠间叶组织来源肿瘤的80%。迄今为止,对于确诊的直肠GIST,外科手术切除仍是最主要和最有效的治疗方法。不同于胃肠道其他部位的GIST,直肠GIST位于狭窄的盆腔内,周围毗邻多个器官和骨盆,且具有复杂的神经支配;此外,直肠位于整个消化道的末端. | 姚宏伟 张忠涛 | 2018 | 中国实用外科杂志2018，38，5： | 6 |
| 3 | 18例直肠间质瘤的诊治分析显示文摘目的:直肠间质瘤(Gastrointestinal stromal tumour,GIST)是相对少见的疾病,缺少统一的治疗规范。本研究探讨直肠间质瘤的临床特点、诊断及治疗方法。方法:对中南大学湘雅医院2002年1月~2009年4月间收治的18例直肠GIST的临床资料、治疗方法及结果进行回顾性分析。结果:直肠GIST的临床表现无特异性,多表现为血便或大便次数增多。CT或MRI显示肿块边界清楚,瘤内有出血坏死及无淋巴结肿大。18例标本免疫组化检测CD117和CD34阳性率均100%。低危险性和极低危险性共8例,占44.4%。全组均经手术治疗,行局部切除12例,直肠前切除术(Dixon)3例,腹会阴联合切除术(Miles)3例。术前以伊马替尼新辅助化疗3例,均达部分缓解(partial response,PR),然后均行局部切除。随访1~84个月,5例患者复发转移,其中3例行伊马替尼治疗,病情稳定。另外2例未接受伊马替尼治疗,死亡1例,另1例反复局部切除后行Miles手术。局部切除组与Miles组的无复发生存时间分别为(75.0±8.4)个月和(26.0±11.1)个月(P=0.023)。结论:直肠GIST的治疗方法应有别于直肠癌,需要制定个体化的外科治疗方案。对大部分低危险性的患者可通过各种手术路径行局部切除而达到满意效果。伊马替尼新辅助化疗的应用,可使部分直肠GIST患者获得保肛机会。 | 刘合利 廖国庆 晏仲舒 张艳仙 尹红玲 | 2010 | 中国肿瘤临床2010，37，6： | 3 |
| 4 | 直肠间质瘤40例临床病理特点和外科治疗显示文摘为探讨直肠间质瘤的临床表现、组织学、免疫组化特点、外科治疗和预后,对收治的40例直肠间质瘤的临床及病理资料进行回顾性分析。将肿瘤侵袭危险度分为无恶性(norisk,NR)、低度恶性(10wrisk,LR)、高度恶性(highrisk,HR)3组,采用Kaplan-Meier限乘法计算生存率及单因素分析,并用Cox多因素回归分析评估患者预后影响因素。结果显示,免疫组化C-kit阳性表达率为82.5%,中位生存时间为52.5个月,术后1、3及5年生存率分别为82.5%、60.0%及42.5%。侵袭危险度评估分级与患者顶后密切相关(P=0.016)。结果表明,直肠间质瘤治疗仍以外科治疗为主,肿瘤侵袭危险度是影响预后的高危因素。 | 郝东明 杨景文 张作兴 | 2015 | 中国肛肠病杂志2015，0，8： | 2 |
| 5 | 胃肠间质瘤20例诊治体会及文献复习显示文摘胃肠道间质瘤(gastrointestinal stromal tumor.GIST)是一种来源于Cajal间质干细胞的胃肠道肿瘤,相对少见,我院2003年3月-2010年10月共收治GIST20例,其中胃间质瘤13例,小肠间质瘤5例,直肠间质瘤2例,给予综合治疗,总结报告如下。 | 任爱军 崔树凡 赵明泉 | 2011 | 中国现代普通外科进展2011，14，10： | 1 |
| 6 | 前入路改良Kugel无张力疝修补术68例临床分析显示文摘目的:探讨前入路改良Kugel无张力疝修补术的临床疗效。方法:68例腹股沟疝患者,全部使用前入路改良Kugel无张力疝修补术,观察手术时间、术后住院时间及术后并发症情况。结果:全部患者切口一期愈合,平均手术时间(70±5)min,平均出院时间(4.0±0.6)d。术后切口血清肿3例,腹膜前血肿1例,切口疼痛5例,阴囊肿胀3例,尿潴留3例,经保守治疗后痊愈。所有患者无切口感染、补片感染等。术后随访1~3年无复发。结论:前入路改良Kugel无张力疝修补术术后恢复快,并发症少,复发率低,值得在临床广泛推广。 | 何守敏 傅军 王守铭 刘新 刘建郭 黄荣晖 | 2018 | 中外医学研究2018，16，5： | 0 |
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