伴有消化道出血胃肠间质瘤危险因素及预后分析

The risk factors and prognosis of gastrointestinal bleeding in gastrointestinal stromal tumor

目的探讨伴有消化道出血的胃肠间质瘤患者的危险因素及预后。方法对241例胃肠间质瘤患者进行回顾性分析,根据是否合并消化道出血分为两组,分析两组患者的临床病理特点、实验室检查、预后。结果单因素分析显示:消化道出血组的性别、T分期、M分期、肿瘤部位、Ki-67、危险度分级与未出血组相比,差异有统计学意义(P<0.05)。Logistic回归分析显示:Ki-67(OR=2.170,95%CI:1.236~5.043)、T分期(OR=1.773,95%CI:1.101~2.854)及肿瘤部位(OR=0.168,95%CI:0.051~0.548)是伴有消化道出血胃肠间质瘤的独立危险因素。生存分析显示,伴有消化道出血的胃肠间质瘤患者预后更差,高危组胃肠间质瘤患者伴有消化道出血对预后的影响更大。结论消化道出血与胃肠间质瘤预后不良有关。Ki-67、T分期及肿瘤部位是伴有消化道出血胃肠间质瘤的独立危险因素。

Objective To explore the risk factors and prognosis of gastrointestinal stromal tumor with gastrointestinal bleeding.Methods The 241 patients who were operated and whose pathological examination was reported as gastrointestinal stromal tumor was analyzed retrospectively.According to whether they had gastrointestinal bleeding or not,the patients were divided into two groups.Differences in clinical characteristics,laboratory examination and prognosis were compared between the two groups.Results Univariate analysis showed that sex,tumor location,tumor diameter,mitotic count,index of Ki-67,tumor risk grade were significantly in gastrointestinal stromal tumor with gastrointestinal bleeding than those in gastrointestinal stromal tumor without bleeding(P<0.05).Logistic regression analysis showed that index of Ki-67(OR=2.170,95%CI:1.236-5.043),tumor diameter(OR=1.773,95%CI:1.101-2.854)and tumor location(OR=0.168,95%CI:0.051-0.548)were independent risk of gastrointestinal stromal tumor with gastrointestinal bleeding.Survival analysis showed that patients with gastrointestinal bleeding had a worse prognosis.The high risk group of gastrointestinal stromal tumor accompanied by gastrointestinal bleeding had a greater impact on the prognosis.Conclusion Gastrointestinal bleeding is associated with poor prognosis of gastrointestinal stromal tumor.Tumor location,tumor diameter and index of Ki-67 are independent risks of gastrointestinal stromal tumor with gastrointestinal bleeding.