胃肠间质瘤术后复发影响因素分析及治疗决策展望

Analysis of factors influencing postoperative recurrence of gastrointestinal stromal tumors and prospects for treatment decision

胃肠道间质瘤唯一可能治愈的手段是外科手术,但是术后复发或转移的风险无法忽视,根据术后风险评估进行靶向治疗是预防复发或转移的关键。影响胃肠道间质瘤术后复发的因素很多,肿瘤大小、肿瘤部位、核分裂像以及肿瘤破裂被认为是独立的危险因素,并根据这些因素制定有风险评估方法,主要包括F/NIH分级标准、AFIP分级标准、2008年改良的NIH分级标准以及列线图模型。虽然这些评估方法确定了预后危险因素指标和危险程度分级,但是均无法准确地评估患者术后复发风险概率,指导临床的准确治疗。因此,我们仍需不断探索影响GIST的预后独立危险因素,建立简单准确的临床评估方法,提高复发风险概率预测的准确性,更好地指导临床个体化治疗,做到精准治疗。

The only possible cure for gastrointestinal stromal tumors is surgery,but the risk of recurrence or metastasis cannot be ignored.Targeted treatment based on postoperative risk assessment is the key to preventing recurrence or metastasis.There are many factors affecting the recurrence of gastrointestinal stromal tumors.Tumor size,tumor location,mitotic figures and tumor rupture are considered to be independent risk factors.According to these criteria,risk assessment methods are developed,mainly including F/NIH grading standards.AFIP grading standards,improved NIH grading standards in 2008,and nomogram models.Although these assessment methods have determined prognostic risk factors and risk grades,they are not able to accurately assess the risk of postoperative recurrence and guide clinical accurate treatment.Therefore,we still need to continuously explore the independent risk factors affecting the prognosis of GIST,establish a simple and accurate clinical evaluation method,improve the probability of recurrence risk probability,better guide clinical individualized treatment,and achieve precise treatment.