2026 年第 2 期 第 21 卷

肝脏原发性胃肠道间质瘤1例并文献复习

Primary gastrointestinal stromal tumor of the liver: a case report and literature review

作者：赵连海1王雯2高立科3王平安4薛栋4

英文作者：Zhao Lianhai1 Wang Wen2 Gao Like3 Wang Ping′an4 Xue Dong4

单位：1山东第一医科大学（山东省医学科学院）研究生部，济南250012；2山东第一医科大学附属滨州市人民医院检验科，滨州256610；3山东省东营市人民医院乳腺甲状腺外科，东营257000；4山东第一医科大学附属滨州市人民医院肝胆外科（山东省医药卫生重点学科-普通外科学），滨州256610

英文单位：1Department of Graduate Shandong First Medical University & Shandong Academy of Medical Sciences Jinan 250012 China; 2Department of Laboratory Binzhou People′s Hospital Shandong First Medical University Binzhou 256610 China; 3Department of Breast and Thyroid Surgery Dongying People′s Hospital Shandong Province Dongying 257000 China; 4Department of Hepatobiliary Surgery Binzhou People′s Hospital Shandong First Medical University (General Surgery a Key Discipline of Medicine and Health in Shandong Province) Binzhou 256610 China

关键词：胃肠道间质瘤；肝脏原发性胃肠道间质瘤；肝切除术；伊马替尼

英文关键词：Gastrointestinalstromaltumor;Primarygastrointestinalstromaltumoroftheliver;Liverresection;Imatinib

• 摘要：

• 肝脏原发性胃肠道间质瘤（GIST）极为罕见，准确诊断存在挑战性。本文报道1例52岁女性肝脏原发性GIST患者，其因体检发现肝脏占位入院，无明显临床症状，既往有十二指肠手术史及1型神经纤维瘤病（NF1）病史。实验室检查肿瘤标志物及肝功能正常，影像学显示肝右叶实性肿块，术前胃肠镜检查未见异常。择期在全身麻醉下行肝部分切除术后病理确诊为梭形细胞型GIST，免疫组织化学示c-Kit、CD34、CD117和DOG-1阳性，术后给予伊马替尼辅助治疗，患者1年后停药，随访10年无复发。肝脏原发性GIST需结合影像学、病理学及免疫组织化学明确诊断，排除转移可能，手术切除联合伊马替尼辅助治疗效果显著。此外，NF1与肝脏原发性GIST的关系有待进一步研究。本文复习了相关文献，为该病的临床诊断、治疗及预后提供一定的参考价值。

• Primary gastrointestinal stromal tumor (GIST) of the liver is extremely rare, and accurate diagnosis is challenging. A 52-year-old female patient with primary hepatic GIST was reported. The patient was admitted to the hospital due to a liver mass detected by physical examination without obvious clinical symptoms. She had a history of duodenal surgery and neurofibromatosis type 1 (NF1). Laboratory tests showed normal tumor markers and liver function, and imaging showed a solid mass in the right lobe of the liver. Preoperative gastrointestinal endoscopy was normal. After elective partial hepatectomy under general anesthesia, the patient was pathologically diagnosed with spindle cell type GIST. Immunohistochemical staining showed c-Kit, CD34, CD117 and DOG-1 were positive. Imatinib was given as adjuvant therapy after surgery, and the drug was stopped after 1 year. There was no recurrence during the follow-up of 10 years. Primary hepatic GIST should be diagnosed by imaging, pathology and immunohistochemistry, and the possibility of metastasis should be excluded. Surgical resection combined with imatinib adjuvant therapy is effective. In addition, the relationship between NF1 and primary hepatic GIST needs to be further studied. This article reviews the relevant literature to provide some reference value for the clinical diagnosis, treatment and prognosis of this disease.