直肠间质瘤40例临床病理特点和外科治疗

The Clinical Pathological Features and Surgical Treatment of Rectal Stromal Tumors in 40 Cases

为探讨直肠间质瘤的临床表现、组织学、免疫组化特点、外科治疗和预后，对收治的40例直肠间质瘤的临床及病理资料进行回顾性分析。将肿瘤侵袭危险度分为无恶性（norisk，NR）、低度恶性（10wrisk，LR）、高度恶性（highrisk，HR）3组，采用Kaplan-Meier限乘法计算生存率及单因素分析，并用Cox多因素回归分析评估患者预后影响因素。结果显示，免疫组化C-kit阳性表达率为82．5％，中位生存时间为52．5个月，术后1、3及5年生存率分别为82．5％、60．0％及42．5％。侵袭危险度评估分级与患者顶后密切相关（P=0．016）。结果表明，直肠间质瘤治疗仍以外科治疗为主，肿瘤侵袭危险度是影响预后的高危因素。

In order to explore the clinical manifestation, histology and immunohistochemistry,as well as surgcial treatment and prognosis of rectal stromal tumors（RST）, authors retrospectively analysed the 40 patient＇s clinical and pathological data, as： differentiate the risk degrees of neoplasm invasion as no risk （NR） ,low risk（LR） and high risk（HR）, then take Kaplan-Meier limited multiplication method to calcu- late survival rate and make single-factor analysis, and by using Cox multi-factor regression analysis evaluate the influence factors on patient＇s prognosis.As results,immunohistochemistry c-kit positive expression rate was 82.5 %, median survival time was 52.5 months, 1,3 and 5-year postoperative survival rate respectively was 82.5%,60.0% and 42.5%, and the evaluation grading of invasive risk degree was closely related to patient＇s prognosis（ P = 0.016）.Results show that for RST surgery still is of main therapy,the risk degree of neoplasm invasion is high-risk factors influencing prognosis.