胃肠道间质瘤临床特征及预后影响因素分析  

Clinical characteristics and prognostic factors of gastrointestinal stromal tumors

作　　者：余永豪 YU Yonghao(General Surgery Department,Yangluo Hospital,the Third People's Hospital of Hubei Province,Hubei Wuhan 430415,China)

机构地区：[1]湖北省第三人民医院阳逻院区普外科,湖北武汉430415

出　　处：《现代肿瘤医学》2021年第18期3251-3254,共4页Journal of Modern Oncology

摘　　要：目的:探讨胃肠道间质瘤临床特征及预后影响因素。方法:回顾性分析我院2011年3月至2014年1月收治的653例胃肠道间质瘤患者临床资料,归纳临床特征,采用统计学方法分析影响预后的危险因素。结果:男女性别比为1.17∶1,年龄分布以40岁以上人群为主(84.07%)。首发症状以消化道出血(37.98%)、腹痛及腹胀(32.01%)、消化道症状(14.85%)为主,部分患者无明显症状(4.44%)。肿瘤发生部位以小肠(20.06%)和胃部(58.35%)为主。581例(88.97%)患者行根治性切除,72例(11.03%)患者行姑息性切除。根治性手术患者中,137例(20.98%)患者行联合脏器切除。112例(17.15%)患者行淋巴结清扫,淋巴结清扫数平均为(23.45±6.12)枚。63例患者术后采用伊马替尼(400 mg/d)口服治疗。371例(56.81%)患者核分裂象≤5个/50 HPF,282例(43.18%)患者核分裂象>5个/50 HPF。CD117阳性581例(88.97%),S-100阳性61例(9.34%),CD34阳性568例(86.98%)。患者1年、3年及5年总体生存率为96.71%、76.52%和61.83%。单因素分析发现核分裂象、肿瘤最大径、手术根治性及改良NIH危险度分级与胃肠道间质瘤患者5年生存率有关,多因素回归分析证实以上因素是影响患者5年生存率的独立危险因素(P<0.05)。结论:胃肠道间质瘤主要分布在40岁以上人群,但临床症状不典型,可通过核分裂象、肿瘤最大径、手术根治性及改良NIH危险度分级评估预后。Objective:To investigate the clinical characteristics and prognostic factors of gastrointestinal stromal tumors.Methods:The clinical data of 653 patients with gastrointestinal stromal tumors treated in our hospital from March 2011 to January 2014 were analyzed retrospectively.The clinical characteristics were summarized and the risk factors affecting prognosis were analyzed by statistical method.Results:The gender ratio of male to female was 1.17∶1,and the age distribution was mainly over 40 years old(84.07%).The first symptoms were gastrointestinal bleeding(37.98%),abdominal pain and abdominal distension(32.01%),digestive tract symptoms(14.85%),and some patients had no obvious symptoms(4.44%).The main sites of tumor occurrence were small intestine(20.06%)and stomach(58.35%).Radical resection was performed in 581 cases(88.97%)and palliative resection in 72 cases(11.03%).In the patients undergoing radical surgery,137 cases(20.98%)underwent combined organ resection.112 patients(17.15%)underwent lymph node dissection,and the average number of lymph node dissection was 23.45±6.12.63 patients were treated with imatinib(400 mg/d)orally after operation.Mitosis were≤5/50 HPF in 371 patients(56.81%)and>5/50 HPF in 282 patients(43.18%).CD117 was positive in 581 cases(88.97%).S-100 was positive in 61 cases(9.34%),and CD34 was positive in 568 cases(86.98%).The 1-,3-and 5-year overall survival rates were 96.71%,76.52%and 61.83%,respectively.Univariate analysis showed that mitosis,maximum diameter of tumor,radical operation and modified NIH risk grade were related to the 5-year survival rate of patients with gastrointestinal stromal tumors.Multivariate regression showed that the above factors were independent risk factors for 5-year survival rate(P<0.05).Conclusion:Gastrointestinal stromal tumors are mainly distributed in people over 40 years old,but the clinical symptoms are not typical.The prognosis can be evaluated by mitosis,maximum diameter of tumor,radical operation and modified NIH risk grade.

关 键 词：胃肠道间质瘤 临床特征 病理 预后 影响因素 

分 类 号：R730.262[医药卫生—肿瘤]