野生型胃肠道间质瘤的临床病理特征及预后影响因素分析  

Clinicopathological Features and Prognostic Factors of Wild-type Gastrointestinal Stromal Tumors

作　　者：秦玲[1] 李道明[1] QIN Ling;LI Daoming(Department of Pathology,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病理科,河南郑州450052

出　　处：《河南医学研究》2022年第20期3707-3711,共5页Henan Medical Research

摘　　要：目的探讨野生型胃肠道间质瘤(GIST)患者的临床病理特征,分析其预后影响因素。方法对郑州大学第一附属医院2013年10月至2020年12月收治的40例野生型GIST患者的临床病理资料进行回顾性分析,对比同时期临床病理资料完整的196例c-kit基因突变型GIST病例,对其临床病理特征进行分析。另对40例野生型GIST进行随访,分析其预后影响因素。结果在40例野生型GIST中男23例,女17例;中位发病年龄55.0岁,年龄范围30~82岁。肿瘤原发于胃者24例(60.0%),小肠15例(37.5%),另有1例(2.5%)患者肿瘤发生于其他部位。40例野生型GIST中,梭形细胞型17例,上皮样细胞型6例,混合型17例。肿瘤最大径范围0.5~15.0 cm。极低危险度、低危险度、中危险度、高危险度分别有5例(12.5%)、8例(20.0%)、13例(32.5%)、14例(35.0%)。CD117阳性率为97.5%(39/40),DOG1阳性率为100.0%(40/40),CD34阳性率为80.0%(32/40)。与经典的c-kit基因突变型GIST比较,野生型GIST肿瘤相对更小,危险度相对更低(P<0.05)。在40例野生型GIST病例中,有30例(75.0%)患者获得随访结果,随访时间为16~101个月。随访过程中,2例复发,1例死亡,平均生存时间94.08个月。随访到的30例中有9例曾服用过靶向药物。肿瘤位置、Ki-67指数与野生型GIST患者的生存相关(P<0.05),但两者均不是影响野生型GIST患者术后生存时间的独立因素(P>0.05)。结论野生型GIST作为独立的GIST亚型,临床病理特征不同于c-kit突变型GIST,生物学行为呈惰性。Objective To investigate the clinicopathological features of patients with wild-type gastrointestinal stromal tumor(GIST)and to analyze the influencing factors of prognosis.Methods The clinicopathological data of 40 patients with wild-type GIST patients admitted to the First Affiliated Hospital of Zhengzhou University from October 2013 to December 2020 were retrospectively analyzed.Compared with 196 cases of c-kit gene mutation GIST patients with complete clinicopathological data during the same period,the clinicopathological characteristics were analyzed.Forty cases of wild-type GIST were followed up to analyze the prognostic factors.Results Among the 40 patients with wild-type GIST,there were 23 males and 17 females.The median age of onset was 55.0 years,and the age range was 30-82 years.The primary tumor was in stomach in 24 patients(60.0%),small intestine in 15 patients(37.5%),and other tumor sites in 1 patient(2.5%).Histological features of the 40 cases of wild type GIST included 17 cases of spindle cell type,6 cases of epithelioid cell type and 17 cases of mixed type.The maximum diameter of the tumor ranged from 0.5 to 15.0 cm.There were 5 cases(12.5%)of extremely low risk,8 cases(20.0%)of low risk,13 cases(32.5%)of medium risk,and 14 cases(35.0%)of high risk,respectively.CD117 positive rate was 97.5%(39/40),DOG1 positive rate was 100.0%(40/40),CD34 positive rate was 80.0%(32/40).Compared with the classic c-kit mutated GIST,wild-type GIST tumors were smaller and the risk was lower(P<0.05).Out of 40 wild-type GIST cases,follow-up results were obtained in 30(75.0%)patients with a follow-up period of 16 to 101 months.During the follow-up period,2 cases recurred and 1 case died,with an average survival time of 94.08 months.Nine of the 30 patients followed up had previously taken targeted drugs.Tumor location and Ki-67 index were related to the survival of patients with wild-type GIST(P<0.05),but neither of them was an independent factor affecting the postoperative survival time of patients with wild-type GIST(P

关 键 词：胃肠道间质瘤 野生型 临床病理特征 预后 

分 类 号：R735[医药卫生—肿瘤]