消化道颗粒细胞瘤临床特征分析
Clinical features of gastrointestinal granular cell tumor:an analysis of 22 cases
张晓静 1赵文君 1孟品 1刘爱玲 1徐楠 2徐永红1
作者信息
- 1. 青岛大学附属医院消化内科,山东青岛 266003
- 2. 大连医科大学附属第一医院麻醉科
- 折叠
摘要
目的 分析消化道颗粒细胞瘤(GCT)的临床特征,提高对消化道GCT的认识及其临床诊治水平.方法 回顾性分析经病理确诊为消化道GCT病人22例的临床资料.结果 22例病人中男17例,女5例,平均年龄(49.36±8.45)岁;发病部位为食管17例(77.27％),回盲部2例(9.09％),结肠3例(13.64％).17例病人表现为非特异性消化道症状,内镜下病灶最大径0.29～2.00 cm.22例行CT检查,6例食管壁略增厚,1例盲肠壁略增厚,余15例未见明显异常.1例行PET-CT检查,食管下段轻度增厚,结节状代谢增高,SUVmax约2.1.22例行内镜检查,病灶黄色15例(68.18％),白色7例(31.82％).13例行超声内镜(EUS)检查,病变起源于黏膜下层7例(53.84％),黏膜肌层5例(38.46％),固有肌层1例(7.70％);病变低回声12例(92.30％),低回声混有少量高回声改变1例(7.70％),回声均匀10例(76.92％),回声欠均匀3例(23.08％).免疫组化检查显示,所有病灶均表达S100,部分表达CD68、SOX10、Ki-67、SDHB、CD34.20例行内镜下治疗,1例行手术治疗,1例随访.病人随访7～69个月,中位随访时间为23个月,除1例病人化疗后失访,余均未见肿瘤复发及转移.结论 消化道GCT以男性为主,临床症状无特异性,内镜、EUS检查相结合可提高对其诊断率,确诊需依据病理学及免疫组化检查,内镜下治疗是安全有效的方法.
Abstract
Objective To investigatethe clinical features of gastrointestinal granular cell tumor(GCT),and to improve the understanding and clinical diagnosis and treatment of gastrointestinal GCT.Methods A retrospective analysis was performed for the clinical data of 22 patients with pathologically confirmed gastrointestinal GCT.Results Among the 22 patients,there were 17 male patients and 5 female patients,with a mean age of(49.36±8.45)years,and the lesion sites were the esophagus in 17 pa-tients(77.27％),the ileocecusin 2 patients(9.09％),and the colon in 3 patients(13.64％).All patients presented with nonspecific gastrointestinal symptoms,and the maximum diameter of endoscopic lesions showed a range of 0.29-2.00 cm.All 22 patients un-derwent CT examination,among whom 6 had slight thickening of the wall of the esophagus and 1 had slight thickening of the wall of the cecum,and no obvious abnormality was observed for the other 15 patients.One patient underwent PET-CT,and the results showed mild thickening of the lower esophagus,with nodular metabolic hyperintensities and a SUVmax value of about 2.1.All 22 patients underwent endoscopic examination,among whom 15(68.18％)had yellow lesions and 7(31.82％)had white lesions.Endo-scopic ultrasound(EUS)was performed for 13 patients,among whom 7(53.84％)had lesions originating from the submucosal la-yer,5(38.46％)had lesions originating from the muscularis mucosa,and 1(7.70％)had lesions originating from the muscularis propria;12 patients(92.30％)had hypoechoic lesions,and 1 patient(7.70％)had hypoechoic lesions mixed with a small amount of hyperechoic changes;10 patients(76.92％)had even echo,and 3(23.08％)had uneven echo.Immunohistochemistry showed the expression of S100 in all lesions and the expression of CD68,SOX10,Ki-67,SDHB,and CD34 in some lesions.Of all 22 patients,20 received endoscopic treatment,1 received surgical treatment,and 1 was followed up.The patients were followed up for 7-69 months,with a median follow-up time of 23 months;1 patient was lost to follow-up after chemotherapy,while the other pa-tients had no tumor recurrence ormetastasis.Conclusion Gastrointestinal GCT is commonly seen in male individuals,with a lack of specific clinical symptoms.The combination of endoscopy and EUS can improve the diagnostic rate of gastrointestinal GCT,and pathology and immunohistochemistry are required to make a con-firmed diagnosis.Endoscopic treatment is currently a safe and effec-tive treatment method.
关键词
颗粒细胞瘤/临床表现/腔内超声检查/病理状态,体征和症状Key words
granular cell tumor/clinical manifestations/en-dosonography/pathological conditions,signs and symptoms引用本文复制引用
基金项目
山东省自然科学基金青年科学基金(Z-R2020QH031)
出版年
2024
国家科技期刊平台
NSTL
万方数据