外科治疗胃间质瘤的预后分析  

Prognosis and long-term outcome of surgical resected gastrointestinal stromal tumors

作　　者：李鹏[1] 黄振[1] 赵宏[1] 窦利州[2] 王杨[1] 郭春光[1] 王贵齐[2] 赵东兵[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院腹部外科,北京100021 [2]北京协和医学院中国医学科学院肿瘤医院腔镜科,北京100021

出　　处：《中国医刊》2015年第11期36-40,共5页Chinese Journal of Medicine

摘　　要：目的探讨胃间质瘤的预后因素及外科治疗远期疗效。方法回顾性分析根治手术治疗的胃间质瘤患者287例,观察因素包括患者临床病理信息,预后指标包括总生存率和无病生存率。结果 287例患者中胃体肿瘤最为多见(76.3%),肿瘤平均直径为6.68cm,所有患者均行R0切除,术中未发生肿瘤破裂。平均核分裂象(5.31±6.15)/50HPF,中位随访时间58.9个月。随访过程中共17例转移,12例死亡。5年、10年总生存率分别为97.7%、91.9%。5年、10年无病生存率分别为91.9%、88.4%。总体生存中坏死和核分裂象>10/50HPF与预后独立相关(P<0.05)。肿瘤直径>10cm及核分裂象>10/50HPF与高复发风险独立相关(P<0.05)。结论胃间质瘤整体预后相对其他部位较好,对于可能根治切除的患者应积极采取外科为主的综合治疗模式,对于术后伴有高危因素患者应密切复查随诊。Objective To investigate the prognostic factors and long-term outcome of surgical treatment for gastric gastrointestinal stromal tumors. Method 281 patients enrolled in this study, clinicopathological data was retrospec-tively analyzed, over-all survival and disease-free survival was applied for assessing the prognosis. Result 16. 3℅ le-sion located in gastric body. All patients underwent radical surgery and no tumor rupture occurred during operation. The mean diameter of tumor was 6. 68cm while mitotic rate was （5. 31±6. 15）/50HPF. Based on the follow-up of 58. 9 months in average, we found the 5-year and 10-year overall and disease-free survival rate was 91. 1℅, 91. 9℅, 91. 9℅ and 88. 4℅ respectively. Necrosis and mitotic rate〉10/50 HPF were independent prognostic fac-tors with overall survival while tumor diameter〉10cm and mitotic rate〉10/50HPF were independent prognostic fac-tors with disease-free survival. Conclusion Gastrointestinal stromal tumors of stomach reveals relatively better prog-nosis, surgery remains first-line treatment for localized lesion. Intensive follow-up should be applied to patients with high recurrence risk.

关 键 词：胃肿瘤 间质瘤 手术 肿瘤复发 预后 

分 类 号：R735.2[医药卫生—肿瘤]