十二指肠胃肠间质瘤临床诊治及预后影响因素  

Diagnose,therapy and prognostic correlation factors of duodenal gastrointestinal stromal tumors

作　　者：黄伟[1] 张卓军[1] 吴雄辉[1] 

机构地区：[1]湛江中心人民医院普外科,广东湛江524037

出　　处：《中华实用诊断与治疗杂志》2015年第12期1220-1222,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨十二指肠胃肠间质瘤临床诊断、治疗及预后影响因素。方法 47例十二指肠胃肠间质瘤患者,22例采用腹腔镜切除术(laparoscopic-assisted resection,LAP)者为LAP组,25例采用开腹行胃肠间质瘤切除术者为开腹组。观察2组手术时间、术中出血量、术后排气时间、住院时间、并发症发生率,随访记录患者1、3、5a生存率。结果本组中27例术前行内镜超声检查者其确诊率为100%;2组术中出血量比较差异无统计学意义(P>0.05),LAP组手术时间[(52.6±13.1)min]、术后排气时间[(2.2±0.6)d]和住院时间[(7.2±2.1)d]短于开腹组[(147.2±44.8)min、(3.4±0.8)d、(10.8±3.1)d)(P<0.05);不同年龄、性别及手术方式患者1、3、5a生存率比较差异无统计学意义(P>0.05);logistic回归分析显示,肿瘤直径(r=-0.731,P=0.036)、有无转移(r=-0.615,P=0.045)和Fletcher分级(r=-0.682,P=0.042)与患者预后呈负相关,肿瘤切除范围与预后呈正相关(r=0.843,P=0.026)。结论术前内镜超声有助于十二指肠胃肠间质瘤的诊断;LAP可作为治疗十二指肠胃肠间质瘤可选方法;瘤体大小、切除范围、有无转移和Fletcher分级与患者预后相关。Objective To investigate the diagnosis, therapy and prognostic correlation factors of duodenal gastrointestinal stromal tumor （DGIST）. Methods In 47 DGIST patients, 22 were performed laparoscopic-assisted resection （LAP group） and 25 were performed open operation （open group）. The operation lasting time, blood loss volume, exhaust time, hospitalization stay and complication incidence were observed and compared between two groups. The 1-, 3-, 5-year survival rates were followed up. Results The diagnostic rate of endoscopic ultrasonography was 100% in 27 patients. There was no significant difference in blood loss volume between two groups （P〉 0.05）. The operation lasting time （（52.6±13.1） min）, postoperative exhaust time （（2.2±0.6） days） and hospitalization stay （（7.2±2.1） days） were significantly shorter in LAP group than those in open group （（147.2±44.8） rain, （3.4±0.8） days, （10.8±3.1） days） （P〈0.05）. There were no significant differences in 1-, 3- and 6-year survival rates in different ages, genders and operations （P〉0.05）. Logistic regression analysis indicated that tumor diameter （r=-0. 731, P= 0. 036）, metastasis （r= -0. 615, P=0. 045） and Fletcher class （r=-0. 682, P=0. 042） were negatively correlated with the prognosis, and the excision extension was positively correlated with the prognosis （r = 0. 843, P=0. 026）. Conclusion Endoscopic ultrasonography contributes to the diagnosis of DGIST. LAP can be chosen as a selective method for DGIST. The tumor diameter, excision extension, metastasis and Fletcher class are correlated with the prognosis.

关 键 词：胃肠间质瘤 十二指肠 预后 

分 类 号：R735[医药卫生—肿瘤]