胃肠间质瘤患者术后复发的相关危险因素分析

Analysis of risk factors for postoperative recurrence in patients with gastrointestinal stromal tumors

目的 采用回顾性研究,对胃肠间质瘤患者术后复发的危险因素进行分析,以制定针对性措施,改善患者预后。方法收集2017年5月—2021年10月洛阳市中心医院收治的133例胃肠间质瘤术后患者的临床资料,对其进行整理分析,并根据术后肿瘤复发情况将患者分为复发组(28例)、未复发组(105例)。对患者的临床资料进行单因素分析,采用多因素非条件Logistic回归对单因素分析中有统计学意义的变量再次进行分析,筛选相关的危险因素。结果 单因素分析结果显示,复发组肿瘤直径>5 cm、肿瘤破裂、核分裂象>5个/50 HPF、侵及周围脏器或组织、R1/R2切除、术后未应用靶向药物治疗的患者人数比例均高于未复发组,且差异均有统计学意义(P<0.05)。多因素非条件Logistic回归分析结果显示:肿瘤直径>5 cm、核分裂象>5个/50 HPF、R1/R2切除、术后未应用靶向药物治疗是胃肠间质瘤患者术后复发的独立危险因素(OR=1.803,1.560,1.675,6.666;P<0.05)。结论 肿瘤直径>5 cm、核分裂象>5个/50 HPF、R1/R2切除、术后未应用靶向药物治疗是胃肠间质瘤患者术后复发的独立危险因素。临床上应提高对存在上述危险因素患者的重视,在患者入院后充分进行评估,早期识别并予以患者相应的预防措施,以降低胃肠间质瘤术后复发风险,改善预后。

Objective This study aimed to conduct a retrospective study to analyze the risk factors for postoperative recurrence in patients with gastrointestinal stromal tumors(GISTs),in order to develop targeted measures to improve patient prognosis.Methods Clinical data of 133 patients with GIST who underwent surgery at Luoyang Central Hospital from May 2017 to October 2021 were collected.The patients were allocated to a recurrence group(n=28)and a non-recurrence group(n=105)according to postoperative tumor recurrence.The clinical data were analyzed and screened,and relevant risk factors were selected by single-factor analysis and multi-factor unconditional logistic regression analysis.Results Of single-factor analysis showed that the proportion of patients with tumor diameter over 5 cm,tumor rupture over 5 mitoses/50 high power fields(HPF),invasion of peripheral organs or tissues,R1/R2 resection,and lack of postoperative targeted drug therapy was significantly higher in the recurrence group than in the non-recurrence group(P<0.05).Multi-factor unconditional logistic regression analysis showed that tumor diameter over 5 cm,tumor rupture over 5 mitoses/50 HPF,R1/R2 resection,and lack of postoperative targeted drug therapy were independent risk factors for postoperative recurrence in patients with GIST(OR=1.803,1.560,1.675,and 6.666,respectively;P<0.05).Conclusion Tumor diameter over 5 cm,tumor rupture over 5 mitoses/50 HPF,R1/R2 resection,and lack of postoperative targeted drug therapy are independent risk factors for postoperative recurrence in patients with GIST.Clinicians should pay attention to patients with these risk factors,conduct full assessments after admission,early identify and administer appropriate preventive measures to reduce the risk of postoperative recurrence and improve prognosis.