肠源性胃肠道间质瘤71例临床分析

Clinical analysis of 71 intestinal origin GIST cases

目的探讨分析肠道来源胃肠道间质瘤(gastrointestinal stromal tumor,GIST)患者的临床和病理特征及影响预后的因素。方法回顾性分析经手术治疗的71例肠源性GIST患者的临床、病理及部分随访资料,对其预后进行单因素分析。结果 71例GIST患者中,病灶原发部位小肠51例,结直肠15例,肠系膜5例。临床表现以消化道出血为主(45.1%,32例),其次为腹部不适及腹部包块(22.5%,16例;16.9%,12例),复发风险极低危1例,低危16例,高危54例。单因素分析显示,肿瘤最大径、核分裂相和复发危险度是影响预后的因素(均P<0.05)。复发风险高危组中,术后服用靶向药物患者的预后好于未服用药物的患者(P<0.05)。结论肿瘤完整切除联合靶向治疗是肠源性GIST的最佳治疗模式,肿瘤最大直径、核分裂相及复发危险度是影响患者预后的危险因素。

Objective To investigate the clinicopathological features of gastrointestinal stromal tumors （GIST） and its prognostic factors. Methods The clinieopathological features and follow-up materials of 71 cases of surgically-treated GIST were analyzed retrospectively. Prognosis related risk factors were evaluated by univariate analysis. Results Among the 71 intestinal origin GIST patients, 51 cases had their primary tumors located in small intestines, 15 cases in coloreetum, and 5 cases in esenterium. The major clinical manifestation was gastrointestinal bleeding （45.1% , 32 cases） , followed by abdominal discomfort and abdominal mass （22.5% , 16 cases; 16.9% , 12 cases）. One ease was evaluated with vel7 low risk of reeurrence, 16 cases with low risk, and 54 cases with high-risk. Univariate analysis showed that the maximum tumor diameter, mitotic phase and recurrence risk were all risk factors of disease prognosis （P 〈 0.05）. Moreover, in patients with high risk of recurrence, patients who took targeted drugs after the surgery have significantly better prognosis than those who did not （P 〈0.05）. Conclusion Complete tumor resection combined with targeted therapy is the best treatment of intestinal G1ST. The maximum tumor diameter, mitotic phase and recurrence risk are independent prognostic factors of in- testinal origin GIST.