胃肠间质瘤161例临床病理特征和预后相关因素分析  

Clinical pathological features and prognosis analysis in 161 cases of gastrointestinal stromal tumors

作　　者：祁义军[1] 孟翔凌[1] 赵文娣[2] 汪正广[1] 李团结[1] 

机构地区：[1]安徽医科大学第一附属医院干部普通外科,合肥230022 [2]安徽医科大学病理学教研室,合肥230032

出　　处：《安徽医科大学学报》2012年第8期963-965,共3页Acta Universitatis Medicinalis Anhui

摘　　要：目的探讨胃肠间质瘤(GIST)的临床病理特征和预后相关因素。方法回顾性分析161例行手术切除治疗的GIST患者的临床病例资料并随访,分别对临床常见症状、肿瘤的部位及大小、核分裂像、免疫组化结果、Fletcher分级等因素进行预后分析。结果腹痛和血便是GIST常见临床表现;免疫组化CD117和CD34的阳性率分别为96.27%和81.36%;肿瘤直径和Fletcher分级在不同部位的GIST之间差异有统计学意义(P<0.05);术后1、3、5年生存率分别为90%、72%、67%;多因素分析显示Fletcher分级、术后辅助甲磺酸伊马替尼(IM)治疗是影响预后的独立危险因素。结论腹痛和血便是GIST的常见临床表现;CD117和CD34是GIST诊断的常用病理指标;Fletcher分级有利于预后评判;靶向治疗能进一步改善预后。Objective To investigate the clinicalpathological features that influence prognosis of gastrointestinal stromal tumors（GIST）.Methods The clinical data of 161 patients underwent surgical resection for GIST and follow-up results were retrospectively reviewed.Results Abdominal pain and bloody stools were main clinical symptoms.The positive rates for the expression of CD117 and CD34 were 96.27% and 81.36% respectively.The contrast of tumor size and Fletcher classification in different location was significant（P〈0.01）.The 1-year,3-year,5-year survival rates of the 161 patients were 90%,72% and 67% respectively.Multivariate analysis indicated that Fletcher classification and targeted therapy with imatinib were independently associated with the prognosis.Conclusion For GIST,abdominal pain and bloody stools are main clinical symptoms;CD117 and CD34 are useful markers for GIST.Fletcher classification is effective to evaluate the prognosis of GIST;Targeted therapy with imatinib can improve survival.

关 键 词：胃肠道间质瘤 病理特征 Fletcher分级 

分 类 号：R735[医药卫生—肿瘤] R656[医药卫生—临床医学]