胃肠道间质瘤预后因素的临床分析  

Clinical analysis of prognostic factors for patients with gastrointestinal stromal tumors

作　　者：揭志刚[1] 谢小平[1] 秦克旺[1] 刘逸[1] 李正荣[1] 戴安邦[1] 姚育修[1] 

机构地区：[1]江西医学院第一附属医院普通外科,南昌330006

出　　处：《中华胃肠外科杂志》2005年第3期210-212,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨影响胃肠道间质瘤(GIST)的预后因素。方法回顾性分析2000-2003年间41例GIST患者的免疫组织化学表达情况及肿瘤的大小、生长部位、核分裂数及手术的切除程度与该病预后的关系。结果GIST患者的病理切片中CD117、CD34和波形蛋白(vimentin)的表达比较高,分别为92.7%、82.9%和78.0%。生长在小肠的GIST比生长在胃和结直肠者预后差(P<0.05);肿瘤直径大于5cm患者的预后较小于或等于5cm的差(3年生存率为54%比72%,P<0.05);核分裂大于5/50HPF者预后较小于或等于5/50HPF者差(P<0.05);行不完全性切除手术者比行完全性切除者预后差(P<0.05)。结论完全性手术切除肿瘤能明显提高GIST患者的预后。生长在小肠的肿瘤、肿瘤直径大于5cm和核分裂大于5/50HPF是影响肿瘤预后的因素。Objective To investigate the prognostic factors for patients wit h gastrointestinal stromal tumors (GIST). Methods From 2000 to 2003,clinical data of 41 cases with GIST were reviewed retrospectively. The clinicopathologic diagn osis was determined by immunochemistry. The relationships of the prognosis with mitotic counts,tumor size and location,range of tumor resection were analyzed. R esults The patients with GIST had pathological section of high expression in CD1 17,CD34 and vimentin(92.7%,82.9%,78%,respectively). Patients with tumor loca tion in intestine,tumor size >5 cm,mitotic counts >5/50HPF,incompleted resection had poorer outcome,compared with those with tumor location in stomach and colon ,tumor size ≤5 cm,mitotic counts ≤5/50HPF and complete resection(all P< 0.05) . Conclusions Complete gross resection can improve prognosis for patients with G IST. Tumors with mitotic counts ≥5/50HPF,tumor size more than 5 cm and tumor lo cation in intestine are poor prognostic factors.

关 键 词：胃肠道间质瘤 预后因素 临床分析 2000-2003年 GIST 免疫组织化学 肿瘤直径 回顾性分析 CD117 3年生存率 表达情况 生长部位 切除程度 核分裂数 病理切片 波形蛋白 CD34 不完全性 手术切除 肿瘤预后 预后差 患者 表达比 

分 类 号：R735[医药卫生—肿瘤] R734.2[医药卫生—临床医学]