胃肠间质瘤47例临床诊治分析

Clinical diagnosis and treatment of gastrointestinal stromal tumors:A report of 47 cases

目的:分析胃肠间质瘤(GISTs)的手术治疗效果及影响因素。方法:回顾性分析47例GISTs患者临床和病理资料及治疗方法并分析影响生存因素。结果:所有47例均手术治疗,43例(91.5%)完全切除。全组术后5年总体生存率为76.3%,5年无病生存率为68.7%。完全切除术后单因素分析显示影响总体生存率的因素有术前转移、肿瘤大小、坏死、核分裂像数目及术后复发(P<0.01)。完全切除后多因素分析发现影响无病生存率的因素为术前转移(P<0.05)及核分裂像数目(P<0.001)。结论:手术完全切除对于GISTs是主要的治疗方法。术前转移及核分裂像数目是GISTs重要的预后因素。

Objective： To analyze the efficacy of surgical management and prognostic factors after surgical resection of gastrointestinal stromal tumors（GISTs）. Methods：The clinical and pathological data and treatment variables of 47 patients of GISTs were analyzed retrospectively to identify factors affecting survival.Results： All patients underwent surgical resection,of the 47 patients, 43 （91.5%）underwent complete surgical resection of macroscopic disease.The 5-year overall survival rate was 76.3% and the 5-year disease-free survival completely resected was 68.7%.Univariate analysis revealed that preoperative metastasis,tumor size, tumor necrosis,mitotic count,and postoperative recurrence were influential factors to overall survival in patients with completed resection （P〈0.01）.On subsequent multivariate analysis revealed that preoperative metastasis and mitotic count were influential factors to disease-free survival in patients with completed resection （P〈0.05,P〈0.001 respectively）.Conclusion：Complete surgical resection is primary treatment for GISTs.Preoperative metastasis and mitotic count are two significant predictors of poor prognosis.