内蒙古地区胃肠道间质瘤804例临床数据分析  

Analysis of clinical data of 804 cases of gastrointestinal stromal tumors in Inner Mongolia

作　　者：李亚鸿 解红霞[2] 王华[2] 赵启军[3] 李明章[4] 宋小燕 杨秀峰[6] 王腾祺[7] 许文剑 刘明[2] Li Yahong;Xie Hongxia;Wang Hua;Zhao Qijun;Li Mingzhang;Song Xiaoyan;Yang Xiufeng;Wang Tengqi;Xu Wenjian;Liu Ming(The First Clinical Medical School,Inner Mongolia Medical University,Hohhot 010050,China;Department of Gastrointestinal Surgery,the Affi liated Hospital of Inner Mongolia Medical University,Hohhot 010050,China;Department of Gastrointestinal Surgery,Baotou Cancer Hospital,Baotou 014000,China;Department of Gastrointestinal Surgery,Baotou City Central Hospital,Baotou 014000,China;Department of Pathology,Inner Mongolia People’s Hospital,Hohhot 010017,China;Department of Gastrointestinal Surgery,Ordos Central Hospital,Ordos 017000,China;Department of Gastrointestinal Surgery,Bayannur City Hospital,Bayannur 015000,China;Department of Gastrointestinal Surgery,Inner Mongolia Autonomous Region Cancer Hospital,Hohhot 010000,China)

机构地区：[1]内蒙古医科大学第一临床医学院,内蒙古自治区呼和浩特010050 [2]内蒙古医科大学附属医院胃肠外科,内蒙古呼和浩特010050 [3]包头市肿瘤医院胃肠外科,内蒙古包头014000 [4]包头市中心医院胃肠外科,内蒙古包头014000 [5]内蒙古自治区人民医院病理科,内蒙古呼和浩特010017 [6]鄂尔多斯市中心医院胃肠外科,内蒙古鄂尔多斯017000 [7]巴彦淖尔市医院胃肠外科,内蒙古巴彦淖尔015000 [8]内蒙古自治区肿瘤医院胃肠外科,内蒙古呼和浩特010000

出　　处：《实用肿瘤杂志》2021年第2期118-124,共7页Journal of Practical Oncology

摘　　要：目的分析内蒙古地区7个临床中心胃肠道间质瘤(gastrointestinal stromal tumors,GIST)数据库中患者的临床病理特征、免疫组织化学、基因分型及预后情况。方法回顾性分析2013年1月至2019年1月间内蒙古地区的GIST数据,分析GIST患者性别、年龄、发病部位、肿瘤直径、核分裂像和美国国立卫生研究院(National Institutes of Health,NIH)改良分级标准等临床特征;对改良NIH标准按年龄段分组进行χ^(2)检验;生存分析采用Kaplan-Meier法。结果内蒙古地区GIST数据库中共纳入患者804例,男性423例,女性381例,男女比例为1.11∶1,中位年龄60岁(20~86岁);最常见的发病位置是胃(465例)和小肠(186例);541例核分裂像≤5/50 high-power field (HPF);肿瘤直径<2 cm、2~5 cm和5.1~10 cm的患者分别有45、276和354例;根据2008年改良NIH标准,极低危、低危、中危和高危患者分别为45、207、210和342例。患者的复发转移在发病部位、核分裂像、肿瘤直径和改良NIH标准方面比较,差异均具有统计学意义(均P<0.05);89.6%的患者同时表达CD117及discovered on GIST 1 (DOG-1),且CD117及DOG-1表达水平差异具有统计学意义(P<0.05);改良NIH标准在各年龄段比较差异无统计学意义(P>0.05)。随访1~10年,满3年的占63.1%。改良NIH标准极低危、低危、中危、高危患者的3年生存率分别为100%、100%、100%和96.3%。结论内蒙古地区的GIST中老年发病率较高,男女无明显差异,主要发病部位为胃和小肠,手术治疗后患者的长期预后较好。Objective To analyze the clinicopathological characteristics,immunohistochemistry,genotyping and prognosis of patients with gastrointestinal stromal tumors(GIST)in 7 clinical centers in Inner Mongolia.Methods Retrospective analysis was performed on GIST patients treated from January 2013 to January 2019 in Inner Mongolia.The clinical characteristics of GIST patients were analyzed,including sex,age,tumor location,tumor size,mitotic index,and modified National Institutes of Health(NIH)criteria.Theχ^(2) test was performed on the modified NIH criteria by age distribution,and Kaplan-Meier method was used for survival analysis.Results A total of 804 GIST patients(423 males and 381 females)were included.The male-to-female ratio was 1.11,and the median age was 60 years(range 20-86 years).The most common sites were stomach(n=465)and small intestine(n=186).Mitotic index was≤5/50 high-power field(HPF)in 541 patients.Forty-five patients had tumor diameter less than 2 cm,276 patients had tumor diameter between 2-5 cm,354 patients had tumor diameter between 5.1-10 cm,and the rest 129 patients had tumor diameter greater than 10 cm.According to the modified NIH criteria in 2008,there were 45,207,210 and 342 patients at very low risk,low risk,intermediate risk and high risk,respectively.There were statistically significant differences in recurrence and metastasis among patients with different tumor location,mitotic index,tumor size,and modified NIH criteria(all P<0.05).CD117 and discovered on GIST 1(DOG-1)were simultaneously expressed in 89.6%of the patients,and the difference in CD117 and DOG-1 expression levels was statistically significant(P<0.05).The modified NIH criteria were independent of age distribution(P>0.05).All patients were followed up for 1-10 years,with 63.1%of them followed up for at least three years.The 3-year survival rates of patients with modified NIH criteria of very low risk,low risk,intermediate risk,and high risk were 100%,100%,100%,and 96.3%,respectively.Conclusions The incidence of GIST in Inner Mon

关 键 词：胃肠道间质瘤 数据库 回顾性研究 

分 类 号：R735[医药卫生—肿瘤]