直肠间质瘤的临床特征及预后分析研究

Clinical characteristics and prognosis of patients with rectal gastrointestinal stromal tumor

目的探讨直肠间质瘤的临床特征及预后。方法回顾性分析苏州大学附属第一医院、苏州大学附属第二医院、吴中区人民医院3家医院从2008年1月到2016年12月间经外科手术后病理及免疫组化确诊的31例直肠间质瘤患者资料，分析其临床特征、治疗方法及预后。结果31例患者中16例行局部切除术，15例行肿瘤根治术，两种术式3年生存率比较差异无统计学意义[93．8％（15／16）比73．3％（11／15），P=0．135]。局部切除术组中口服伊马替尼与不口服伊马替尼的患者生存率分别为75．0％（3／4）和100．0％（12／12），差异无统计学意义（P：0．083）；肿瘤根治术组中口服伊马替尼与不日服伊马替尼的患者生存率分别为77．8％（7／9）和66．7％（4／6），差异亦无统计学意义（P=0．579）。局部切除术组与肿瘤根治术组的术后复发转移率差异无统计学意义[31．3％（5／16）比53．3％（8／15），P=0．213]。结论直肠间质瘤外科手术术式的选择对患者生存情况及术后复发无显著影响；口服伊马替尼与否对患者的生存情况无明显影响。

Objective To analyze the clinical characteristics and prognosis of patients with rectal gastrointestinal stromal tumor （GIST）. Methods We collected the data of 31 rectal GIST patients definitely demonstrated by pathology and immunohistoehemistry in the First Affiliated Hospital of Soochow University, the Second Affiliated Hospital of Sooehow University, and Suzhou Wuzhong People＇s Hospital from January 2008 to December 2016. The clinical characteristics, therapeutic modalities, and prognoses were retrospectively analyzed. Results Among the 31 rectal GIST patients, 16 underwent local resection and 15 underwent radical surgery. There was no significant difference on the three-year survival rate between the two groups[93.8% （15/16） VS 73.3% （11/15）, P= 0. 135]. There was no significant difference on the survival rate between the oral imatinib patients and non-oral imatinib patients in the local resection group [75.0% （3/4） VS 100. 0% （ 12/12）, P=0. 0831 and the radical surgery group[77.8% （7/9） VS 66. 7% （4/6）, P=0. 5791. The postoperative recurrence and metastasis rate of the two groups was no significantly different[31.3% （5/16） VS 53.3% （8/15）, P=0.213]. Conclusion The choice of surgical procedure has no significant effects on the survival rate and postoperative recurrence for rectal GIST patients, and whether oral imatinib or not has no significant effects on the survival of patients.