胃肠间质瘤术后复发转移的危险因素及预后分析

Risk Factors and Prognosis of Postoperative Recurrence and Metastasis of Gastrointestinal Stromal Tumor

[目的]探讨胃肠间质瘤(GIST)术后复发转移的危险因素及预后,为防治GIST的术后复发转移提供理论指导。[方法]回顾性分析经手术治疗的287例GIST患者临床资料。应用Log-rank单因素分析及COX回归模型多因素分析进行数据处理。[结果] 287例患者术后发生复发转移94例,截止随访日存活201例,死亡86例。单因素分析显示原发部位、肿瘤大小、核分裂相、手术根治度、术后靶向药物治疗是GIST术后复发转移及影响生存率的危险因素。多因素分析显示肿瘤大小(P=0.018)、核分裂象(P=0.012)、危险度分级(P=0.010)、手术根治度(P=0.009)、术后靶向药物治疗(P=0.010)是影响术后复发转移的独立因素。肿瘤大小(P=0.023)、核分裂相(P=0.017)、危险度分级(P=0.005)、手术根治度(P=0.003)、术后靶向药物治疗(P=0.004)及术后复发转移(P=0.003)是术后生存的独立影响因素。[结论] GIST的肿瘤大小、核分裂相、危险度分级、手术根治度、术后靶向药物治疗是影响术后复发转移及预后的独立因素。

[Objective] To investigate the risk factors and prognosis of postoperative recurrence and metastasis of gastrointestinal stromal tumor(GIST). [Methods] The clinical data of 287 GIST patients who underwent surgical treatment from January 2008 to January 2018 were retrospectively analyzed. Log-rank univariate analysis and Cox regression model multivariate analysis were used for data processing. [Results] There were 94 cases of postoperative recurrence and metastasis;and201 surviving cases and 86 fatal cases among 287 GIST patients. Univariate analysis showed that the primary site,tumor size,mitotic count,radical resection,postoperative targeted drug therapy were the risk factors of recurrence and metastasis and survival rate of GIST. Multivariate analysis showed that tumor size(P=0.018),mitotic count(P=0.012),risk grade(P=0.010),radical resection(P=0.009)and postoperative targeted drug therapy(P=0.010) were independent factors affecting postoperative recurrence and metastasis. Tumor size(P=0.023),mitotic count(P=0.017),risk grade(P=0.005),radical resection(P=0.003),postoperative targeted drug therapy(P=0.004) and postoperative recurrence and metastasis(P=0.003) were independent factors affecting postoperative survival. [Conclusion]Tumor size,mitotic count,risk grade,radical resection and targeted drug therapy are independent factors affecting recurrence,metastasis and prognosis of GIST.