胃肠道间质瘤原发灶大小与预后的关系

Prognostic significance of primary tumor size in gastrointestinal stromal tumor

目的 探讨胃肠道间质瘤 (gastrointestinalstromaltumor,GIST)原发肿瘤大小与预后的关系。方法 对92例能完全切除的GIST患者的临床资料和病理切片 (含免疫组织化学检查 )重新复核并进行随访 ,分析原发肿瘤大小与预后的关系。结果 中位生存时间为 5 9 1个月 ,术后 2 ,5年生存率分别为 89 38%和 6 7 4 5 %。原发灶肿瘤完全切除术患者的生存率与其性别、肿瘤部位和大小、肿瘤性质、核分裂及复发转移有关 ;但多因素的Cox回归分析显示 ,术后生存率仅与肿瘤大小、肿瘤性质和复发转移相关 (P <0 0 5 )。以 2cm为界比较生存率有统计学意义 (P <0 0 5 ) ,5cm为界比较生存率无统计学意义 (P >0 0 5 )。结论 GIST仍以外科治疗为主 ,胃肠道间质瘤原发灶大小是影响预后的独立高危因素 ,肿瘤直径≥

Objective To analyze the prognostic significance of primary tumor size in gastrointestinal stromal tumors (GIST). Methods Clinical data and pathological sections including immunohistochemical staining sections of 92 patients with GIST from January 1990 to October 2003 were reviewed and all patients were followed. Correlation between tumor size and outcomes was studied. Results The median survival duration was 59 1 months. The overall survival rate at 2 and 5 year was 89 38% and 67 45%,respectively. Sex, tumor sites, preoperative metastasis, tumor size, pathology type, karyokinesis and recurrence-metastasis were correlated with survival for patients with tumor resected completely in univariate analysis, but only tumor size, pathology type, recurrence and metastasis were correlated with survival by Cox multivariate regression analysis( P <0 05). The difference between the survival of two groups divided by 2 cm was statistically significant( P <0 05),but the difference between groups divided by 5 cm was not statistically significant( P >0 05). Conclusion Surgery is still the main treatment for GIST. Tumor size was an independent prognostic factor in patients with GIST. Patients with tumor size more than 2 cm should be intensively followed.