上消化道间质瘤的随访及侵袭危险性的相关因素分析

周雪; 陈瑶; 吴玥; 彭贵勇

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上消化道间质瘤的随访及侵袭危险性的相关因素分析

论著 | 更新时间：2026-01-09

- 上消化道间质瘤的随访及侵袭危险性的相关因素分析
- Analysis of related factors of tumors invasion risk in patients with upper gastrointestinal stromal tumors
- 陆军军医大学学报 2014年36卷第8期页码：816-820
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  中图分类号： R181.32;R730.4;R735
- 纸质出版：2014
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周雪,陈瑶,吴玥,彭贵勇.上消化道间质瘤的随访及侵袭危险性的相关因素分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(08):816-820.

　Zhou Xue,Chen Yao,Wu Yue,Peng Guiyong.Analysis of related factors of tumors invasion risk in patients with upper gastrointestinal stromal tumors[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(08):816-820.
周雪,陈瑶,吴玥,彭贵勇.上消化道间质瘤的随访及侵袭危险性的相关因素分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(08):816-820. DOI：

　Zhou Xue,Chen Yao,Wu Yue,Peng Guiyong.Analysis of related factors of tumors invasion risk in patients with upper gastrointestinal stromal tumors[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(08):816-820. DOI：

摘要

目的通过分析上消化道间质瘤内镜及超声内镜特点与侵袭危险性的关系，及随访上消化道间质瘤患者的临床结果，探讨内镜预测上消化道间质瘤的侵袭危险性的价值及如何选择不同的处理方式。方法回顾性分析2003年3月至2011年12月经超声内镜（endoscopic ultrasound，EUS）诊断为上消化道间质瘤的292例患者的临床资料，对手术和内镜切除的标本行病理检查明确其侵袭危险性，并分析其胃镜及超声内镜影像特点与侵袭危险性的关系。对部分上消化道间质瘤患者行胃镜及超声内镜随访观察其肿瘤变化情况。结果肿瘤大小，表面、回声、形态、边界这5个内镜特征与侵袭危险性相关。肿瘤大于3 cm，尤其是肿瘤表面出血溃烂、回声不均、形态不规则、边界不清的内镜和超声特点提示肿瘤有中度和高度侵袭危险性。肿瘤小于3 cm，表面光滑、均匀低回声、形态规则、边界清楚的内镜及超声特点提示其侵袭危险性较低。对非手术患者平均随访24个月，≤1 cm组、1～2 cm组、2～3.5 cm组的肿瘤增长率分别为0.8%、8.8%及12.5%。结论内镜与超声内镜可预测上消化道胃肠间质瘤（gastrointestinal stromal tumors，GIST）的侵袭危险性。≤2 cm的上消化道GIST，其恶性潜能较低，宜选择保守治疗，可定期临床随访，2～3 cm的GIST恶性潜能介于低度和中度之间，可进行密切随访或外科及内镜切除，大于3 cm的GIST恶性潜能较高，应采取外科或内镜切除。

Abstract

Objective By analyzing the endoscopic and endosonographic features of upper gastro intestinal stromal tumors and their relation with tumor invasion risks

as well as following-up the clinical outcomes of patients

to evaluate endoscopy measures for prediction of tumor invasion risks and different treatment choices. Methods The clinical data of 292 patients with upper gastrointestinal stromal tumors diagnosed by endoscopic ultrasound (EUS) in our institute from March 2003 to December 2011 were analyzed retrospectively. The surgical and endoscopic resection specimens were subjected to pathological examination to clarify its invasion risk. The relation between the endoscopic and endosonographic features and the malignant potential was analyzed. Some patients were followed up to observe the changes in the tumors. Results EUS features of tumor size

surface

echo

shape and boundary showed statistically significant relation to tumor invasion risks. Tumors larger than 3 cm

especially with mucosal ulceration

non-oval shape

irregular extraluminal border and heterogeneous echo texture indicated moderate or high tumor invasion risks. Tumors smaller than 3 cm

with smooth surface

homogeneous hypoecho

regular shape and clear boundary suggested low tumor invasion risks. For non-surgical patients

follow-up results (average 24 months) showed that the tumor growth rates were 0.8%

8.8% and 12.5% of tumor size ≤1 cm group

tumor size 1 to 2 cm group

and tumor size 2 to 3.5 cm group

respectively. Conclusion The endoscopic and endosonographic features of upper gastrointestinal stromal tumors can be used to predict the invasion risk. Tumors with size not greater than 2 cm have low malignant potential and can be treated conservatively with regular clinical follow-up. The tumors with size 2 to 3 cm have low to medium malignant potential

and can be treated with surgical and endoscopic resection or close follow-up. The tumors with size greater than 3 cm have high malignant potential

and need to be treated with surgical or endoscopic resection.

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