伊马替尼疗效与晚期胃肠间质瘤临床病理特征分析

Analysis of the curative effect of Imatinib and clinicopathological features in advanced gastrointestinal stromal tumor

目的探讨晚期胃肠间质瘤(GIST)临床病理特征对伊马替尼疗效的影响。方法回顾性分析74例晚期GIST患者的临床病理资料,并比较不同因素对伊马替尼疗效的影响。结果全组病例有效率(RR)为87.8%。性别、年龄、肿瘤原发部位与伊马替尼疗效无关(P>0.05)。单因素分析显示:危险度、转移灶手术情况、转移病灶与伊马替尼疗效有关(P<0.05)。多因素分析显示:转移灶手术情况、转移病灶是伊马替尼疗效的独立影响因素。逻辑回归分析显示:肝脏与多脏器转移,腹盆腔与多脏器转移的伊马替尼疗效差异有统计学意义(P<0.05)。结论危险度、转移灶手术情况、转移病灶是GIST伊马替尼疗效的影响因素,其中转移灶手术情况、转移病灶是伊马替尼疗效的独立影响因素;腹盆腔转移、肝脏转移、多脏器转移的伊马替尼疗效依次降低。

Objective To explore the effect of clinicopathological features on the curative effect of Imatinib in advaced gastrointestinal stromal tumor （ GIST） . Methods Retrospectively analyzed the clinicopathological data of 74 diagonosed patients with advanced GIST by histopathology and immunohistochemistry between September 2007 and July 2012 in The First Affiliated Hospital of Anhui Medical University. The impact factors of the curative effect of Imatinib were evaluated. Results The response rate of the curative effect of Imatinib in all patients was 87. 8%. The statistical analysis showed that there was no correlation between the curative effect of Imatinib and gender,age, tumor primary site（P〉0. 05）. The univariate analysis revealed that risk,dissection of primary tumor,metastatic lesion are related to the curative effect of Imatinib （ P〈0 . 05 ） . The multivariate analysis revealed that dissection of primary tumor and metastatic lesion are independent factors impacting the curative effect of Imatinib. The Logistic regression analysis showed that there were significant differences between multiple organic metastasis and hepatic metastasis as well as between multiple organic metastasis and abdominal and pelvic metastasis （ P〈0 . 05 ） . Conclusion Risk, dissection of primary tumor, metastatic lesion are the impact factors of the curative effect of Imatinib. And dissection of primary tumor and metastatic lesion are independent factors impacting the curative effect of Imatinib. The curative effect of Imatinib in different metastatic lesion of abdominal and pelvic metastasis, hepatic metastasis and multiple organic metastasis are decreased in turn.