胃肠道间质瘤的临床病理特征与预后的相关性分析  

An analysis on clinical features and prognostic factors of gastrointestinal stromal tumors

作　　者：李杰华[1] 张海添[1] 陈之白[1] 苏卡[1] 

机构地区：[1]广西医科大学第一附属医院胃肠腺体,南宁530021

出　　处：《中华普通外科杂志》2013年第5期360-363,共4页Chinese Journal of General Surgery

基　　金：外科基金项目：国家自然科学基金资助项目（81160274）

摘　　要：目的探讨影响胃肠道间质瘤患者的预后因素。方法回顾性分析1996年1月至2011年12月在广西医科大学第一附属医院收治的144例胃肠道间质瘤患者的临床资料。采用Kaplan-Meier方法、COX比例风险回归模型和log-rank检验分析影响胃肠道间质瘤患者预后的因素。结果本组病例5年总生存率为59．6％。单因素分析显示，患者的预后与肿瘤位置、肿瘤大小、有无远处转移、手术方式、肿瘤细胞类型、周围脏器组织有无侵犯、肌层有无受侵、肿瘤细胞密集程度、核分裂象数目、Ki-67、P53、有无接受酪氨酸激酶抑制剂治疗等因素有关（均P〈0．05）；多因素分析显示，肿瘤大小、有无远处转移、手术方式、周围脏器组织有无侵犯、肿瘤细胞密集程度、核分裂象数目、P53、有无接受酪氨酸激酶抑制剂治疗是影响患者预后的重要因素。结论早期诊断和以手术为主、辅以酪氨酸激酶抑制剂治疗的综合治疗能够提高胃肠道间质瘤患者的生存率。Objective To study the prognostic factors of gastrointestinal stromal tumors（GIST）. Methods A total of 144 GIST patients treated at the First Affiliated Hospital of Guangxi Medical University between January 1996 and December 2011 were analyzed restrospectively. Kaplan-Meier, log-rank test and Cox regression model were used. Results The overall 5-year survival was 59. 6%. Log-rank univariate survival analysis showed that the primary location, tumor size, metastasis, operational method, type of tumor cells, invasion of the surrounding organs and tissues, invasion of the smooth muscle, cellularity of the tumor, mitotic counts of the tumor cells, Ki-67 labeling index, P53 expression and targeting therapy were significant prognostic factors （P 〈 0.05）. Cox regression model showed that tumor size, metastasis, operational method, surrounding organs and tissues invasion, cellularity of the tumor, mitotic counts of the tumor cells, P53 and targeting therapy were essential to improve the survival. Conclusions The study suggests that early diagnosis and comprehensive treatment consisting of operation and targeting therapy can significantly improve the survival of GIST.

关 键 词：胃肠道间质肿瘤 病理学 临床 预后 回归分析 

分 类 号：R735[医药卫生—肿瘤]