肿瘤原发位置与消化道出血对术后胃肠间质瘤患者预后的影响  

Effective predictors of the primary tumor location and gastrointestinal bleeding in the prognosis of gastrointestinal stromal tumor after surgery

作　　者：苏东亮[1] 寇有为[1] 王强[1] 

机构地区：[1]中国医科大学附属盛京医院胃肠营养减重外科,辽宁沈阳110004

出　　处：《中国现代普通外科进展》2015年第6期463-466,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨不同部位及首发症状胃肠间质瘤(GIST)的预后。方法:回顾性分析2004年1月—2014年5月收治的初次经手术完全切除的118例GIST患者的临床资料。结果:病灶原发于胃57例,十二指肠7例,小肠30例,直肠9例,消化道外腹腔病灶15例。118例全部完整手术切除,术后使用甲磺酸伊马替尼辅助治疗。胃GIST复发率显著低于其他部位(P≤0.05),术后生存情况更好;与其他症状为首发的患者相比,以消化道出血为首发症状的GIST患者术后复发率差异并无统计学意义(P>0.05),但术后生存情况较差。结论:胃部占位的GIST预后较好,表现为消化道出血的GIST预后较差。Objective： The diagnosis and treatment of gastrointestinal stromal tumors （GIST） were investigated in this study. Patients with pathologically confirmed GIST were ＇followed up by telephone. The information of the patients were recorded. The outcomes of the patients whose tumors developed in different sites and who had different first symptoms were compared and analyzed. The relationship between the prognoses of the postoperative GIST patients and the primary sites of tumors and digestive hemorrhage, as well as the potential effects of both factors on the prognosis of GIST were investigated. Methods： The clinical materials of 118 cases who had pathologically confirmed GIST and underwent radial resection in our hospi＇tal from January 2004 to May 2014 were collected and analyzed. Comparison of the reoccurrence rate and survival analysis were performed to determine the effects of the primary sites of tumors （stomach or outside of stomach） and the first symptoms （digestive hemorrhage or not） on the prognoses of the patients. Results： These 118 patients were diagnosed with GIST by postoperative pathological examination. The primary sites of tumors included stomach （n=57）, duodenum （n=7）, small intestine （n=30）, rectum （n=9） and outside of digestive tract （abdominal cavity） （n=15）. The tumors of the patients were completely removed by surgery. The patients took imatinib mesylate as adjuvant therapy after operation. Conclusions： The reoccurrence rate of the patients who developed tumors in stomach was significantly lower than the patients with other primary sites （P〈0.05） and the patients whose primary tumor site was stomach also had a better survival rate than other patients showed by the survival curve. There was no significant difference in the reoccurrence rate of the patients with digestive hemorrhage as the first symptom and the patients with other first symptoms（P〉0.05）. However, the survival curve showed the patients with the first symptom of digestive h

关 键 词：胃肠间质瘤 胃 消化道出血 预后 

分 类 号：R735.2[医药卫生—肿瘤] R735.3[医药卫生—临床医学]