8 例胃神經鞘瘤的臨床診治分析_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

李忠生 ^1,2 , 李星龍 ^1,2 ,  李國東 ^1,2 , 于曉彤 ^1,2 , 黨樹偉 ^1,2 , 張淑君 ³ , 畢丹丹 ³

1. ;
2. ;
3. ;

Corresponding?author：

李國東, Email: jonathanlgd@163.com

Keywords：

胃神經鞘瘤; 臨床診斷; 治療

DOI：

10.7507/1007-9424.201810056

Video：

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目的分析胃神經鞘瘤（gastric schwannoma，GS）的臨床及病理特征并總結其診斷和治療方法。方法回顧性分析哈爾濱醫科大學附屬第四醫院普外科于 2013–2017 年期間收治的 8 例 GS 患者的臨床病例資料，包括一般資料、臨床表現、診斷方法、治療手段等。結果 8 例患者均進行手術治療，其中 4 例行腹腔鏡胃腫瘤切除，3 例行開腹胃腫物切除，1 例采用腹腔鏡、胃鏡雙鏡聯合胃腫物切除。對患者術后隨訪 2～50 個月，8 例患者均未復發。GS 鏡下的梭形細胞和“淋巴細胞套”是其最顯著特點。免疫組織化學染色 S-100 呈彌漫性陽性。結論 GS 是一種發生于胃黏膜下的腫瘤，多為良性，其臨床表現不典型，主要可表現為腹痛和腹脹，胃鏡和 CT 檢查難以確診該病，免疫組織化學檢查結果是目前診斷該病的金標準，手術切除是有效的治療方法。

Citation： 李忠生, 李星龍, 李國東, 于曉彤, 黨樹偉, 張淑君, 畢丹丹. 8 例胃神經鞘瘤的臨床診治分析. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(4): 476-479. doi: 10.7507/1007-9424.201810056 Copy

1.	Vargas Flores E, Bevia Pérez F, Ramirez Mendoza P, et al. Laparoscopic resection of a gastric schwannoma: A case report. Int J Surg Case Rep, 2016, 28: 335-339.
2.	朱音, 李昌水, 鄭江江, 等. 胃神經鞘瘤 5 例臨床病理分析. 現代實用醫學, 2015, 27(10): 1368-1370.
3.	Yoon HY, Kim CB, Lee YH, et al. Gastric schwannoma. Yonsei Med J, 2008, 49(6): 1052-1054.
4.	Ohno T, Ogata K, Kogure N, et al. Gastric schwannomas show an obviously increased fluorodeoxyglucose uptake in positron emission tomography: report of two cases. Surg Today, 2011, 41(8): 1133-1137.
5.	胡寶光. 胃神經鞘瘤的研究現狀. 消化腫瘤雜志 (電子版), 2015, 7(3): 133-135.
6.	Ji JS, Lu CY, Mao WB, et al. Gastric schwannoma: CT findings and clinicopathologic correlation. Abdom Imaging, 2015, 40(5): 1164-1169.
7.	Tao K, Chang W, Zhao E, et al. Clinicopathologic features of gastric schwannoma: 8-year experience at a single institution in China. Medicine (Baltimore), 2015, 94(45): e1970.
8.	邱云峰, 杜琪威, 楊維良. 胃神經鞘瘤的臨床特點及診治 (附 21 例報告). 腹部外科, 2015, 28(1): 44-46, 49.
9.	Watanabe A, Ojima H, Suzuki S, et al. An individual with gastric schwannoma with pathologically malignant potential surviving two years after laparoscopy-assisted partial gastrectomy. Case Rep Gastroenterol, 2011, 5(2): 502-507.
10.	邱靜, 楊順清, 梁曉東, 等. 胃間質瘤及神經鞘瘤的臨床病理特征及鑒別診斷分析. 臨床與實驗病理學雜志, 2014, 30(8): 911-914.
11.	Zheng L, Wu X, Kreis ME, et al. Clinicopathological and immunohistochemical characterisation of gastric schwannomas in 29 cases. Gastroenterol Res Pract, 2014, 2014: 202960.
12.	Yoon JM, Kim GH, Park DY, et al. Endosonographic features of gastric schwannoma: a single center experience. Clin Endosc, 2016, 49(6): 548-554.
13.	吳玉珍, 倪萍, 林燕, 等. 胃神經鞘瘤的 MSCT 影像學表現分析. 中國醫療設備, 2014, 29(10): 144-146.
14.	Akazawa Y, Ueyama H, Nagahara A, et al. Case of computed tomography (CT) gastrography for the detection of multiple gastric submucosal tumors: a case report. Nihon Shokakibyo Gakkai Zasshi, 2014, 111(10): 1968-1975.
15.	李忠生, 李國東, 劉明. 胃神經鞘瘤的研究現狀. 中國普外基礎與臨床雜志, 2017, 24(12): 1541-1545.
16.	姜勝東. 胃神經鞘瘤的多層螺旋 CT 診斷價值. 醫學影像學雜志, 2013, 23(3): 424-426.
17.	盛衛忠, 劉寒, 紀元, 等. 腹腔鏡手術治療胃間葉源性腫瘤的臨床研究. 外科理論與實踐, 2012, 17(2): 143-146.
18.	Sreevathsa MR, Pipara G. Gastric schwannoma: a case report and review of literature. Indian J Surg Oncol, 2015, 6(2): 123-126.
19.	孫龍. 胃神經鞘瘤臨床病理分析. 中國現代醫生, 2015, 53(29): 109-115.
20.	Voltaggio L, Murray R, Lasota J, et al. Gastric schwannoma: a clinicopathologic study of 51 cases and critical review of the literature. Hum Pathol, 2012, 43(5): 650-659.
21.	Williamson JM, Wadley MS, Shepherd NA, et al. Gastric schwannoma: a benign tumour often mistaken clinically, radiologically and histopathologically for a gastrointestinal stromal tumour—a case series. Ann R Coll Surg Engl, 2012, 94(4): 245-249.
22.	Manji M, Ismail A, Komba E. Gastric schwannoma: Case report from Tanzania and brief review of literature. Clin Case Rep, 2015, 3(7): 562-565.
23.	張再重, 王雯, 王烈. 雙鏡聯合技術在結直腸腫瘤中的應用. 中華胃腸外科雜志, 2015, 18(6): 540-543.
24.	彭濤, 婁展, 趙軼峰, 等. 雙鏡聯合治療胃叢狀神經鞘瘤. 中華胃腸外科雜志, 2017, 20(7): 829-830.

1. Vargas Flores E, Bevia Pérez F, Ramirez Mendoza P, et al. Laparoscopic resection of a gastric schwannoma: A case report. Int J Surg Case Rep, 2016, 28: 335-339.
2. 朱音, 李昌水, 鄭江江, 等. 胃神經鞘瘤 5 例臨床病理分析. 現代實用醫學, 2015, 27(10): 1368-1370.
3. Yoon HY, Kim CB, Lee YH, et al. Gastric schwannoma. Yonsei Med J, 2008, 49(6): 1052-1054.
4. Ohno T, Ogata K, Kogure N, et al. Gastric schwannomas show an obviously increased fluorodeoxyglucose uptake in positron emission tomography: report of two cases. Surg Today, 2011, 41(8): 1133-1137.
5. 胡寶光. 胃神經鞘瘤的研究現狀. 消化腫瘤雜志 (電子版), 2015, 7(3): 133-135.
6. Ji JS, Lu CY, Mao WB, et al. Gastric schwannoma: CT findings and clinicopathologic correlation. Abdom Imaging, 2015, 40(5): 1164-1169.
7. Tao K, Chang W, Zhao E, et al. Clinicopathologic features of gastric schwannoma: 8-year experience at a single institution in China. Medicine (Baltimore), 2015, 94(45): e1970.
8. 邱云峰, 杜琪威, 楊維良. 胃神經鞘瘤的臨床特點及診治 (附 21 例報告). 腹部外科, 2015, 28(1): 44-46, 49.
9. Watanabe A, Ojima H, Suzuki S, et al. An individual with gastric schwannoma with pathologically malignant potential surviving two years after laparoscopy-assisted partial gastrectomy. Case Rep Gastroenterol, 2011, 5(2): 502-507.
10. 邱靜, 楊順清, 梁曉東, 等. 胃間質瘤及神經鞘瘤的臨床病理特征及鑒別診斷分析. 臨床與實驗病理學雜志, 2014, 30(8): 911-914.
11. Zheng L, Wu X, Kreis ME, et al. Clinicopathological and immunohistochemical characterisation of gastric schwannomas in 29 cases. Gastroenterol Res Pract, 2014, 2014: 202960.
12. Yoon JM, Kim GH, Park DY, et al. Endosonographic features of gastric schwannoma: a single center experience. Clin Endosc, 2016, 49(6): 548-554.
13. 吳玉珍, 倪萍, 林燕, 等. 胃神經鞘瘤的 MSCT 影像學表現分析. 中國醫療設備, 2014, 29(10): 144-146.
14. Akazawa Y, Ueyama H, Nagahara A, et al. Case of computed tomography (CT) gastrography for the detection of multiple gastric submucosal tumors: a case report. Nihon Shokakibyo Gakkai Zasshi, 2014, 111(10): 1968-1975.
15. 李忠生, 李國東, 劉明. 胃神經鞘瘤的研究現狀. 中國普外基礎與臨床雜志, 2017, 24(12): 1541-1545.
16. 姜勝東. 胃神經鞘瘤的多層螺旋 CT 診斷價值. 醫學影像學雜志, 2013, 23(3): 424-426.
17. 盛衛忠, 劉寒, 紀元, 等. 腹腔鏡手術治療胃間葉源性腫瘤的臨床研究. 外科理論與實踐, 2012, 17(2): 143-146.
18. Sreevathsa MR, Pipara G. Gastric schwannoma: a case report and review of literature. Indian J Surg Oncol, 2015, 6(2): 123-126.
19. 孫龍. 胃神經鞘瘤臨床病理分析. 中國現代醫生, 2015, 53(29): 109-115.
20. Voltaggio L, Murray R, Lasota J, et al. Gastric schwannoma: a clinicopathologic study of 51 cases and critical review of the literature. Hum Pathol, 2012, 43(5): 650-659.
21. Williamson JM, Wadley MS, Shepherd NA, et al. Gastric schwannoma: a benign tumour often mistaken clinically, radiologically and histopathologically for a gastrointestinal stromal tumour—a case series. Ann R Coll Surg Engl, 2012, 94(4): 245-249.
22. Manji M, Ismail A, Komba E. Gastric schwannoma: Case report from Tanzania and brief review of literature. Clin Case Rep, 2015, 3(7): 562-565.
23. 張再重, 王雯, 王烈. 雙鏡聯合技術在結直腸腫瘤中的應用. 中華胃腸外科雜志, 2015, 18(6): 540-543.
24. 彭濤, 婁展, 趙軼峰, 等. 雙鏡聯合治療胃叢狀神經鞘瘤. 中華胃腸外科雜志, 2017, 20(7): 829-830.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

8 例胃神經鞘瘤的臨床診治分析

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