Chinese Journal of Practical Surgery

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  • Online:2018-05-01 Published:2018-04-27

盆底区域胃肠间质瘤27例临床病理学特征和预后分析

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  1. 北京大学人民医院  a.胃肠外科，b.外科肿瘤研究室，北京100044

Abstract:

Clinical pathological features and prognosis analysis of 27 patients for gastrointestinal stromal tumor of pelvic floor        ZHANG Shu-wei*，GAO Zhi-dong, DAI Rui-ning, et al. *Department of Gastrointestinal Surgery, Peking University People’s Hospital, Beijing 100044, China
Corresponding authors: YE Ying-jiang, E-mail: yeyingjiang@pkuph.edu.cn; GAO Zhi-dong, E-mail: gaozhidong@pkuph.edu.cn
ZHANG Shu-wei and GAO Zhi-dong are the first authors who contributed equally to the article
Abstract    Objective    To explore clinical features and prognostic factors of GIST of pelvic floor patients. Methods   The clinicopathological data of 27 GIST of pelvic floor patients admitted from September 2005 to July 2017 in Peking University People’s Hospital were analyzed retrospectively. The prognosis was evaluated by univariate analysis. Results A total of 27 GIST patients were collected, including 16 males and 11 females. The median age of onset was 52,ranged from 27 to 81 years old. The median tumor size was 3.0 cm. The predominant site of tumor origin was from rectum (17 cases,68.0%), while the posterior regions of prostate and bladder, the posterior vaginal wall, the rectovaginal septum, the anterior sacral region, and the bladder were also seen. The 1-, 3- and 5-year survival rates of all patients were 100.0%,92.9%,73.1%, while 6 cases（25.0%） of the patients developed recurrence or metastasis. Univariate analysis revealed that the factors impacting the prognosis were tumor size, surgical methods and preoperative infiltration or metastasis. Considering two factors of tumor diameter and mitotic count among 24 patients, 5-year survival rates of the cases with the maximum diameter of the tumor less than 5 cm and the mitotic image less than 5/50HPF were 100.0% vs. 54.7%, respectively,which compared with the other patients,the difference was statistically significant. Conclusion    The symptoms of GIST of pelvic floor are dormant and difficult to diagnose. Preoperative imaging examination is helpful in preoperative diagnosis of tumor sources. Tumor size> 5cm or mitotic> 5/50HPF indicates poor prognosis.

Key words: gastrointestinal stromal tumor, pelvic floor, clinical characteristics, prognosis

摘要：

目的    分析盆底区域胃肠间质瘤（GIST）病人的临床病理学特征及影响预后的因素。方法    回顾性分析2005年9月至2017年7月间北京大学人民医院收治的27例病理学检查确诊为盆底区域GIST病人的临床资料，并进行单因素预后分析。 结果    27例盆底区域GIST病人，男性16例，女性11例，发病年龄52（27~81）岁；肿瘤中位最大径3.0 cm；肿瘤原发部位以直肠最为多见（17例，68.0%），其次是前列腺、膀胱后方区域、阴道后壁、直肠阴道隔、骶前区、膀胱；病人术后1、3、5年的存活率分别为100.0%、92.9%、73.1%，有6例（25.0%）病人发生了复发或转移；单因素生存分析显示，肿瘤大小、手术方式、术前浸润或转移是影响盆底区域GIST病人预后的因素；综合考虑肿瘤直径与核分裂像计数两种因素后对24例病人进行分析，肿瘤最大径≤5 cm且核分裂像计数≤5/50HPF的病人与其他病人相比，5年总存活率分别为100.0% vs. 54.7%，差异有统计学意义（χ2=5.158，P=0.023）。 结论    盆底区域GIST起病隐匿，症状多样，术前影像学检查有助于术前协助诊断肿瘤来源。肿瘤最大径＞5 cm或核分裂像计数＞5/50HPF可能提示盆底区域GIST病人预后较差。

关键词: 胃肠间质瘤, 盆底, 临床特征, 预后