十二指肠间质瘤19例的诊治与预后

Treatment and Prognosis of 19 Patients with Duodenal Gastrointestinal Stromal Tumors

【目的】分析位于十二指肠的胃肠道间质瘤(GIST)的临床诊断、治疗效果及其影响因素。【方法】对中山大学肿瘤防治中心1990年1月至2009年10月治疗的19例十二指肠GIST临床资料复核并加以随访回顾分析。所有参数均采用SPSS16.0统计软件处理,分析完全切除14例和不完全切除5例的生存率和有关影响因素。【结果】十二指肠GIST多见于十二指肠降部和水平部,最常见症状为消化道出血。全组1～、2～和5～年生存率分别为94.4%、77.3%和61.8%,完全切除术后1～、2～和5～年生存率分别为100%、80.0%和80.0%,不全切除术后为80%、0%和0%,完全切除术组患者生存率明显优于不完全切除术组(P<0.05)。完全切除组中局部切除和扩大切除之间无显著差异(P>0.05)。【结论】十二指肠GIST仍以外科治疗为主,其手术方式的选择更多取决于肿瘤的部位和大小,伊马替尼可改善患者预后。

Objective To analyze clinical characteristics and surgical treatment effects for the patients with duodenal gastrointestinal stromal tumors（GIST） and influential factors.Methods In the retrospective study,the clinical data and the tissue slices including immunohistochemical staining of 19 patients with duodenal GIST from January 1990 to October 2009 were rechecked,and all patients were followed up.SPSS 16.0 for windows software package was used for statistical analysis.The survival rate and related factors were analyzed in the two groups.Results Common lesions of duodenal GIST located in the descending and transverse portion.Common symptoms of duodenal GIST were alimentary tract hemorrhage.The overall survival rates at 1-,2-,and 5-year were 94.4%,77.3%,and 61.8%,respectively.The patients with tumor resected completely survival rates at 1-,2-,and 5-year were 100%,80.0%,and 80.0% but the patients with tumor resected incompletely were 80%,0%,and 0%.There was significant difference in survival rate between complete resection group and incomplete resection group（P0.05）,but the significant difference was not detected between local resection and extended resection（P 0.05）.Conclusion Surgery is still the main treatment for duodenal GIST.The surgical program is mainly determined by the location and size of tumor.Local complete resection is the principal treatment.Imatinib can improve the prognosis of the patients with duodenal GIST.