中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (04): 297-300.

• 论著 • 上一篇    下一篇

胃肠间质瘤172例治疗及预后分析

王    刚，张汝鹏，赵敬柱，王学军，柯    彬，梁    寒   

  1. 天津医科大学附属肿瘤医院胃部肿瘤科 天津市肿瘤防治重点实验室, 天津300060
  • 出版日期:2010-04-01 发布日期:2010-04-06

  • Online:2010-04-01 Published:2010-04-06

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摘要：

目的    探讨胃肠间质瘤（GIST）的治疗及影响预后的因素。方法    回顾性分析2001年1月至2007年12月天津医科大学附属肿瘤医院收治的经手术治疗的172例GIST病人的临床病理资料，并比较不同因素对预后的影响。结果  153例获随访病人1、3、5年存活率分别为 96.0%、82.6%、60.5%。单因素分析显示，肿瘤大小、肿瘤完整切除、核分裂像数目、肿瘤侵犯其他脏器、伴发转移、Fletcher分级和口服甲磺酸伊马替尼，对存活率有影响（P<0.05）；多因素分析显示，伴发转移、Fletcher分级和口服甲磺酸伊马替尼是预后的独立影响因素（P<0.05）。结论    伴发转移是影响预后的独立危险因素，同时Fletcher分级是判断GIST生物学行为及预后简单有效的方法，手术是治疗GIST的主要方法，靶向治疗能进一步改善GIST的预后。

关键词: 胃肠间质瘤, 外科手术, 甲磺酸伊马替尼

Abstract:

Treatment and prognosis of gastrointestinal stromal tumor:an analysis of 172 patients        WANG Gang, ZHANG Ru-peng, ZHAO Jing-zhu, et al. Department of Gastric Cancer, Cancer Institute and Hospital of Tianjin Medical University, Tianjin 300060, China 
Corresponding author: ZHANG Ru-peng, E-mail: zhangrp @hotmail.com
Abstract    Objective    To investigate treatment and prognostic factors of gastrointestinal stromal tumors (GIST). Methods    The clinicopathological data of 172 patients with GIST admitted between January 2001 and December 2007 were analyzed retrospectively and the prognostic factors were evalutated. Results    The 1-,3- and 5-year survival rates of the 153 patients followed up were 96.0%, 82.6% and 60.5% respectively. Univariate analysis revealed that the tumor size, complete tumor resection，mitotic count，infiltrated to surrounding tissue, preoperative metastasis， Fletcher classification and adjuvant postoperative therapy with imatinib were related to the survival rates. Multivariate analysis demonstrated that preoperative metastasis，Fletcher classification and adjuvant postoperative therapy with imatinib were the independent prognostic factors for survival. Conclusion    For GIST, preoperative metastasis is the independent factor predicting poor prognosis； Fletcher classification is effective to evaluate the behaviors and prognosis；Surgery is the main therapy and targeted therapy can improve survival.

Key words:  , gastrointestinal stromal tumors；surgical procedures；imatinib mesylate