十二指肠与空回肠间质瘤临床病理特征比较及预后影响因素  

Comparison of clinicopathological features and prognostic factors of duodenal and jejunoileum gastrointestinal stromal tumors

作　　者：单治理 SHAN Zhili(Department of General Surgery,Suzhou Dushu Lake Hospital(Dushu Lake Hospital Affiliated to Soochow University),Jiangsu Province,Suzhou215000,China)

机构地区：[1]苏州市独墅湖医院(苏州大学附属独墅湖医院)普外科,江苏苏州215000

出　　处：《中国当代医药》2022年第29期20-23,共4页China Modern Medicine

摘　　要：目的分析十二指肠间质瘤(D-GIST)和空回肠间质瘤(JI-GIST)临床病理特征以及影响术后复发和预后的危险因素。方法回顾性分析2008年1月至2017年8月苏州市独墅湖医院收治的92例小肠间质瘤患者资料,其中D-GIST 23例,JI-GIST 69例,分析其临床病理特征及复发和预后的影响因素。结果临床病理特征方面,两组患者首发症状不同,D-GIST最常见的首发症状为消化道出血(52.2%),JI-GIST最常见的首发症状为腹痛(39.1%),差异有统计学意义(P<0.05);JI-GIST肿瘤直径>5 cm的比例和高危患者比例高于D-GIST,差异有统计学意义(P<0.05);JI-GIST术后总复发率高于D-GIST组,差异有统计学意义(P<0.05);两组患者术后总生存率比较,差异无统计学意义(P>0.05)。多因素Cox分析显示,肿瘤直径>5 cm、核分裂象>5/50 HPF是影响小肠间质瘤患者复发的独立危险因素;年龄>60岁、肿瘤直径>5 cm、核分裂象>5/50 HPF是影响小肠间质瘤患者生存预后的独立危险因素。结论较JI-GIST,D-GIST更易早期确诊,术后复发风险低。要重点关注肿瘤直径>5 cm和核分裂象>5/50 HPF及老年患者的术后情况,减少复发,改善预后。Objective To analyze the clinicopathological characteristics of duodenal stromal tumors(D-GIST)and jejunoileum stromal tumors(JI-GIST)and the risk factors for postoperative recurrence and prognosis.Methods The data of 92 patients with small intestinal stromal tumors admitted to Suzhou Dushu Lake Hospital from January 2008 to August 2017 were retrospectively analyzed,including 23 cases of D-GIST and 69 cases of JI-GIST.The clinicopathological features,recurrence and prognostic factors were analyzed.Results In terms of clinicopathological characteristics,the first symptoms of the two groups were different.The most common first symptom of D-GIST was gastrointestinal bleeding(52.2%),while the most common first symptom of JI-GIST was abdominal pain(39.1%),and the difference was statistically significant(P<0.05).The proportion of JI-GIST tumor diameter>5 cm and the proportion of high-risk patients were higher than those of D-GIST,and the differences were statistically significant(P<0.05).The total recurrence rate of JI-GIST was higher than that of D-GIST group,and the difference was statistically significant(P<0.05).There was no significant difference in overall survival rate between the two groups(P>0.05).Multivariate Cox analysis showed that tumor diameter>5 cm and mitotic figure>5/50 HPF were independent risk factors for recurrence of small intestinal stromal tumor.Age>60 years,tumor diameter>5 cm,mitotic figure>5/50 HPF were independent risk factors for survival and prognosis of patients with small intestinal stromal tumors.Conclusion Compared with JI-GIST,D-GIST is easier to be diagnosed early and has a lower risk of postoperative recurrence.To reduce recurrence and improve prognosis,we should pay more attention to tumor diameter>5 cm,mitotic figure>5/50 HPF and elderly patients.

关 键 词：十二指肠间质瘤 空回肠间质瘤 临床病理特征 复发 预后 

分 类 号：R735[医药卫生—肿瘤]