139例胃肠道间质瘤患者临床疗效及预后分析

Clinical efficacy and prognosis of 139 patients with gastric stromal tumor

目的探讨胃肠道间质瘤(GISTs)的外科治疗效果及其影响因素。方法回顾性分析2008~2014年在长海医院接受手术治疗并经病理证实的139例GISTs患者的相关临床资料,采用Kaplan-Meier法绘制生存曲线(log-rank检验)和Cox多因素回归分析影响因素。结果139例患者均接受手术切除,随访率达87.77%。全组患者术后1、3、5年生存率为96.72%、85.25%、77.87%;1、3、5年无疾病进展生存率95.08%、81.97%、77.87%。单因素分析影响GISTs总生存时间以及无疾病进展生存时间的因素为肿瘤大小、核分裂像、肿瘤危险分级(P<0.05);多因素Cox回归分析显示,患者术后生存率与肿瘤危险分级、核分裂像相关(P<0.05)。采用腹腔镜手术术中手术时间缩短,出血量减少(P<0.05);术后进食时间以及出院时间明显早于开腹手术方式的患者(P<0.05)。结论GISTs治疗以外科手术为主,肿瘤危险分级、核分裂像是影响GISTs患者术后预后的独立危险因素。腹腔镜下行GISTs切除术,患者创伤小,恢复快。

Objective To analyze the outcome of the patients with gastric gastrointestinal stromal tumor (GIST) after surgical treatment and identify the associated risk factors. Methods 139 gastric GISTs patients with confirmed pathologically were included from 2008 to 2014. Their clinical datas were retrospectively analyzed. Results The follow up rate was 87.77%. The overall survival( OS) of 1,3 and 5 years were 96.72%,85.25% and 77.87%,The PFS of 1,2,3 years were 95.08%,81.97%,77.87% respectively. Single factor survival analysis showed that OS had significant association with tumor size,mitotic index and tumor risk grading. However,only tumor risk grading,karyokinesis were associated with survival rates by Cox regression multivariable analysis. Conclusion Surgery is the main treatment for gastric GIST. tumor risk grading,karyokinesis are potential prognostic factor of gastric GISTs.Laparoscopic reception of gastric stromal tumors can be performed safely and patients can recover quickly.