高危胃肠外间质瘤临床特征及预后分析  

Clinical Features and Prognostic Factors of High-Risk Extragastrointestinal Stromal Tumor

作　　者：李通 殷向阳 米吾楠 刘伟强 张朕 姜建武 刘琪[1] 符洋[1] LI Tong;YIN Xiangyang;MI Wunan;LIU Weiqiang;ZHANG Zhen;JIANG Jianwu;LIU Qi;FU Yang(Gastrointestinal Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院胃肠外科,河南郑州450052

出　　处：《河南医学研究》2021年第17期3105-3109,共5页Henan Medical Research

基　　金：国家自然科学基金(81871995)。

摘　　要：目的探讨高危胃肠外间质瘤(EGIST)的临床表现、病理特征及预后的影响因素。方法回顾性分析郑州大学第一附属医院2011年12月至2016年12月确诊的41例高危EGIST患者的临床资料,并与同期121例高危胃肠道间质瘤(GIST)患者信息进行比较。通过生存曲线寻找高危EGIST患者预后的影响因素。结果高危EGIST患者年龄22~80岁,中位年龄61岁,肿瘤直径为2~30 cm,中位直径为10 cm。EGIST组肿瘤直径>10 cm者、CD34阴性者、接受开放手术者占比高于GIST组(P<0.05)。10例EGIST患者复发转移,其中3例于术后1 a内复发,无进展生存期(PFS)短于高危GIST患者(P<0.05)。肿瘤位置和Ki-67指数是高危EGIST患者复发的危险因素(P<0.05),肿瘤位于肠系膜、Ki-67指数>10%的患者更易复发。结论高危EGIST比高危GIST恶性程度高,预后差,肿瘤位于肠系膜和Ki-67指数>10%的高危EGIST患者预后更差。Objective To investigate the clinical manifestations,pathological characteristics and prognostic factors of high-risk extragastrointestinal stromal tumor(EGIST).Methods The clinical data of 41 high-risk EGIST patients diagnosed in the First Affiliated Hospital of Zhengzhou University from December 2011 to December 2016 were retrospectively analyzed and compared with the data of 121 high-risk gastrointestinal stromal tumor(GIST)patients diagnosed during the same period.The survival curve was used to find the factors affecting the prognosis of high-risk EGIST patients.Results High-risk EGIST patients were 22 to 80 years old,with a median age of 61 years.The diameter of the tumor was 2-30 cm,with a median diameter of 10 cm.The rates of tumor diameter>10 cm,CD34 negative,and open surgery in the EGIST group were higher than those in the GIST group(P<0.05).Ten patients with EGIST recurred and metastasized,and 3 of them recurred within 1 year after surgery.The progression free survival(PFS)of high-risk EGIST patients was shorter than that of high-risk GIST patients(P<0.05).Tumor location and Ki-67 index were risk factors for recurrence in high-risk EGIST patients(P<0.05).Patients with tumors located in the mesentery and Ki-67 index>10%were more likely to relapse.Conclusions High-risk EGIST is more malignant and has a worse prognosis than high-risk GIST.The prognosis of high-risk EGIST patients with tumors located in the mesentery and Ki-67 index>10%is worse.

关 键 词：胃肠道间质瘤 胃肠外间质瘤 临床特征 复发 预后 

分 类 号：R730.262[医药卫生—肿瘤]