57例胃间质瘤预后分析

Prognostic analysis of 57 cases with gastric gstrointestinal stromal tumors

目的:探讨胃间质瘤手术治疗后肿瘤复发及患者生存的影响因素。方法:对2006年1月至2012年6月新疆肿瘤医院收治的57例胃GIST患者临床病理和随访资料进行回顾性分析。结果:57例胃GIST患者中复发、转移10例(17.5%),主要发生部位为肝脏及腹腔。1年和3年无复发生存率分别是93%和84%。单因素分析显示,术后复发转移与核分裂象(>5/50 HPF)、肿瘤直径(>10cm)、Fletcher分级高有关;核分裂象(>5/50 HPF)、复发转移与患者生存有关。结论:手术治疗是局部可切除原发GIST的标准治疗。Fletcher分级标准是评估GIST复发转移比较公认的指标。对于高危或复发转移胃GIST患者,建议服用伊马替尼治疗。

Objective:To analyze prognostic factors influencing tumor recurrence and survival after curative resec-tion of primary gastric GIST.Methods:The clinicopathological features of 57 cases with gastric GIST underwent surgi-cal resection between January 2006 and June 2012 at the Affiliated Tumor Hospital of Xinjiang Medical University were retrospectively reviewed.Clinical features and outcomes were analyzed.Results:Fifty-seven patients(31 males and 26 females)with a median age of 58 years(range,33 -76 years)were reviewed.Ten patients(17.5%)devel-oped tumor recurrence,the most common organs of recurrence were liver and intraperitoneal.The recurrence -free probability at 1 and 3 years were 93%and 84%respectively.Univariable analysis showed that mitotic count(>5/50 HPF),tumor size(>10cm)and Fletcher's classification high-risk were significant predictors of recurrence survival and that mitotic count(>5/50 HPF)and recurrence were significant prognostic factors.Conclusion:Surgical treat-ment remains the gold standard therapy for resectable GISTs.Fletcher's classification is the most important factor for predicting the recurrence or metastasis.Imatinib mesylate should be advocated for patients with high -risk gastric GIST or recurrence.