胃肠道外间质瘤21例临床分析

Extra-gastrointestinal Stromal Tumors: A Clinical Analysis of 21 Cases

目的:探讨胃肠道外间质瘤(EGIST)的临床特征、诊治及预后。方法:回顾性分析2012年1月至2015年7月川北医学院附属医院收治的21例EGIST患者的临床资料。结果:EGIST好发于肠系膜及网膜,分别占42.9%、33.3%;EGIST在肿瘤直径(≥10cm)、侵犯周围器官、危险度及恶性生物学行为均高于肠道GIST(P<0.05)。EGIST的R0切除率仅42.9%,合并脏器切除占61.9%,只有25%的患者术后进行分子靶向治疗,EGIST的1、2年总生存率为76.3%、42.4%,1、2年无进展生存率为68.0%、37.8%。结论:EGIST比肠道GIST有更高的不良生物学行为和更差的预后,合理的靶向治疗和手术时机是改善EGIST患者预后的有效手段。

Objective： To investigate the clinical features,diagnosis,treatment and prognosis of the extra-gastrointestinal stromal tumors（ EGIST）. Methods： The clinical data of 21 patients with EGIST treated in the Affiliated Hospital of North Sichuan Medical College from January 2012 to July 2015 were retrospectively analyzed. Results： EGIST mainly occured in mesentery（ 42. 9%） and omentum（ 33. 3%）. In patients with EGIST compared with those with intestinal GIST,the tumor diameter（ ≥10cm）,invading to surrounding organs,degree of risk and malignant biological behavior were significantly increased（ all P〈0. 05）. Of the 21 patients,42. 9% cases underwent R0 resection,61. 9% cases had synchronous resection of other organs,25% cases with high degree of risk were treated by Imatinib after surgery. The 1-and 2-year overall survival rate of patients with EGIST was 76. 3% and 42. 4%,respectively,and the 1-and 2-year progressive-free survival rate was 68. 0% and 37. 8%,respectively. Conclusion： Comparing with intestinal GIST,the EGIST has higher adverse biological behaviour and worse prognosis. Rational molecular targeted therapy and timing of surgery may be the effective approach to improve the outcomes of the EGIST patients.