胃肠道间质瘤的临床病理特征及预后相关因素分析

The Analysis of the Clinicopathological Features and Prognostic Factors of Gastrointestinal Stromal Tumors

目的：探讨分析胃肠道间质瘤的临床病理特征及预后相关因素。方法2010年10月～2013年10月在本院手术切除并病理证实的148例胃肠道间质瘤患者作为研究对象，收集患者血便率，腹痛率，腹胀率，结节数，瘤体直径，CD34、CD117、SMA、S-100阳性率，以及性别、年龄、肿瘤性质等资料并做统计分析。结果148例GIST患者中血便72例（48.65%），腹痛65例（43.92%），腹胀62例（41.89%）。单发肿瘤者占69.59%（103/148），多发者30.41%（45/148），CD117、CD34、SMA、S-100阳性率分别为91.22%（135/148），52.70%（78/148），36.49%（54/148），25.68%（38/148）。性别、肿瘤直径、临床症状以及免疫组化染色结果均对胃肠道间质瘤预后无影响（P〉0.05），年龄和肿瘤性质是影响胃肠道间质瘤预后的因素，年龄越大，肿瘤恶性程度越高，预后越差（P〈0.05）。结论胃肠道间质瘤患者常有腹痛、血便、腹胀等症状，肿瘤多为单发结节，CD117和CD34呈弥漫性阳性表达，SMA和S-100主要呈局灶性分布，年龄大和肿瘤恶性程度较高的患者预后较差，而性别、肿瘤直径、临床症状、免疫组化染色并不影响GISTs的预后。因此，临床上遇到因腹痛、血便、腹胀等症状而就诊的患者应引起足够的重视，并及早发现，及早治疗。

Objective To investigate and analyze the clinicopathological features and prognostic factors of gastrointestinal stromal tumors. Methods 148 cases of gastrointestinal stromal tumor patients in our hospital from October 2010 to October 2013 were collected as research subjects. the bloody diarrhea rate, abdominal pain rate , bloating rate, nodules, tumors diameter, CD34, CD117, SMA, S-100-positive rate, as well as data of gender, age, tumor nature were selected and made statistical analysis. Results The rate of bloody diarrhea, abdominal pain, abdominal distension, single tumor were 48.65% （72/148）, 43.92% （65/148）, 41.89% （62/148）, 69.59% （ 103/148 ）, mainly by 30.41%（45/148）, CD117, CD34, SMA, S-100 positive rates were 91.22%（ 135/148 ） , 52.70%（ 78/148 ） , 36.49%（54/148 ）, 25.68%（38/148 ） . Gender, tumor size, clinical symptoms and results of immune histo chemical staining were no gastrointestinal stromal tumor on prognosis （P〉0.05）, age and nature of the tumor was gastrointestinal stromal tumor prognostic factors, the greater the age, The higher the degree of malignancy, the worse the prognosis （P〈0.05）. Conclusion Patients with gastrointestinal stromal tumors often have abdominal pain, bloody diarrhea, bloating and other symptoms, tumors were solitary nodule, CD117 and CD34 positive diffuse, SMA and S-100 was main focal distribution, older and a high degree of malignancy in patients with a poor prognosis, and gender, tumor size, clinical symptoms, staining does not affect the prognosis of GISTs. Therefore, patients experiencing abdominal pain, bloody diarrhea, bloating and other symptoms and treatment should cause enough clinical attention, and early detection and early treatment..