胃肠道外间质瘤预后因素分析

Prognostic Factors for Extragastrointestinal Stromal Tumors Patients

目的探讨胃肠道外间质瘤(EGIST)的临床特征及影响预后的因素。方法回顾性分析2006年1月至2011年5月间河南省肿瘤医院收治的首次进行外科治疗且经病理证实的35例胃肠道外胃肠间质瘤患者的临床及随访资料,采用SPSS17.0进行统计学分析,计数资料用卡方检验,应用KaplanMeier曲线计算生存率,影响生存率的单因素分析采用Log rank检验,多因素预后分析应用Cox回归模型(向前逐步回归法)。结果全组患者1、2、3年生存率分别为81.6%、57.3%、35.3%;接受R0切除的患者术后复发或转移18例(51.4%)。Cox多因素回归分析显示,肿瘤复发或转移(RR:2.269,95%CI:1.055~4.880)、周围组织侵犯(RR:3.386,95%CI:1.142~10.044)、肿瘤出血坏死(RR:3.015,95%CI:1.120~4.880)及肿瘤破裂(RR:8.085,95%CI:2.517~25.967)是影响本组EGIST患者预后的独立因素。结论 EGIST患者症状隐匿,不易诊断,首次就诊时肿瘤体积往往较大。肿瘤复发或转移、周围组织侵犯、肿瘤出血坏死及肿瘤破裂是影响本组EGIST患者预后的独立因素。

Objective To explore clinical features and prognostic factors of extragastrointestinal stromal tumors(EGSTs). Methods We retrospectively analyzed clinicopathological data of 35 EGSTs patients admitted from January 2006 to May 2011 in Henan Tumor Hospital by SPSS17.0. Kaplan-Meier and Cox regression(forward stepwise regression) analysis were used to evaluate the prognostic factors(P<0.05). Results 1-, 2- and 3-year survival rates of all EGST patients were 81.6%, 57.3% and 35.3%; 18 patients(51.4%) with R0 resection developed recurrence or metastasis. Cox regression analysis showed that the surrounding tissue invasion(RR: 3.386, 95% CI: 1.142-10.044), tumor recurrence or metastasis(RR: 2.269, 95% CI: 1.055-4.880), tumor hemorrhage necrosis(RR: 3.015,95%CI: 1.120-4.880) and tumor rupture(RR: 8.085,95%CI: 2.517-25.967) were independent prognostic factors. Conclusion EGIST symptoms are dormant and difficult to diagnose, with large volume at first. Surrounding tissue invasion, tumor recurrence or metastasis, tumor hemorrhage necrosis and rupture are independent prognostic factors.