Tao Kaixiong, Chang Weilong, Zhao Ende, Deng Rui, Gao Jinbo, Cai Kailin, Wang Guobin, Zhang Peng
From the Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Medicine (Baltimore). 2015 Nov;94(45):e1970. doi: 10.1097/MD.0000000000001970.
To explore the clinicopathologic characteristics, diagnosis, treatment, and prognosis of gastric schwannoma in the imatinib era.The clinicopathologic characteristics and postoperative outcomes of patients diagnosed with gastric schwannoma at our institution between January 2007 and February 2015 were retrospectively collected and analyzed.The main patient complaint was epigastric pain or discomfort. Tumor sizes ranged from 15 to 80 mm (mean, 57.1 mm). In 17 patients, the tumors were located in the body of the stomach. A total of 20 patients were preoperatively misdiagnosed with a gastrointestinal stromal tumor. The rate of correct preoperative diagnosis was only 3.3%. All patients underwent surgical resection and showed strong S-100 protein positivity. Laparoscopic surgery for gastric schwannoma was associated with less blood loss and a shorter postoperative hospital stay than open surgery (P < 0.01). Total 28 patients were disease free without recurrence or metastasis at a median follow-up time of 50 months.Gastric schwannoma is often preoperatively misdiagnosed as gastric gastrointestinal stromal tumor. Laparoscopic resection of gastric schwannoma is considered safe and effective, and it may be the preferred surgery for most small- and moderate-sized tumors. The long-term outcome is excellent, as this type of neoplasm is uniformly benign.
探讨伊马替尼时代胃神经鞘瘤的临床病理特征、诊断、治疗及预后。回顾性收集并分析2007年1月至2015年2月在我院诊断为胃神经鞘瘤患者的临床病理特征及术后结果。主要患者主诉为上腹部疼痛或不适。肿瘤大小范围为15至80毫米(平均57.1毫米)。17例患者肿瘤位于胃体部。共有20例患者术前被误诊为胃肠道间质瘤。术前正确诊断率仅为3.3%。所有患者均接受手术切除,且S-100蛋白呈强阳性。与开腹手术相比,腹腔镜手术治疗胃神经鞘瘤出血量更少,术后住院时间更短(P<0.01)。中位随访时间50个月时,28例患者无疾病复发或转移。胃神经鞘瘤术前常被误诊为胃胃肠道间质瘤。腹腔镜切除胃神经鞘瘤被认为是安全有效的,可能是大多数中小尺寸肿瘤的首选手术方式。由于这类肿瘤均为良性,长期预后良好。