胃肠间质瘤161例临床病理特征和预后相关因素分析

摘要

Objective To investigate the clinicalpathological features that influence prognosis of gastrointestinal stromal tumors( GIST ) . Methods The clinical data of 161 patients underwent surgical resection for GIST and follow-up results were retrospectively reviewed . Results Abdominal pain and bloody stools were main clinical symptoms . The positive rates for the expression of CD117 and CD34 were 96. 27% and 81. 36% respectively. The contrast of tumor size and Fletcher classification in different location was significant ( P <0. 01 ). The 1-year, 3-year , 5-year survival rates of the 161 patients were 90% , 72% and 67% respectively . Multivariate analysis indicated that Fletcher classification and targeted therapy with imatinib were independently associated with the prognosis . Conclusion For GIST, abdominal pain and bloody stools are main clinical symptoms ;CD117 and CD34 are useful markers for GIST. Fletcher classification is effective to evaluate the prognosis of GIST; Targeted therapy with imatinib can improve survival .%目的 探讨胃肠间质瘤(GIST)的临床病理特征和预后相关因素.方法 回顾性分析161例行手术切除治疗的GIST患者的临床病例资料并随访,分别对临床常见症状、肿瘤的部位及大小、核分裂像、免疫组化结果、Fletcher分级等因素进行预后分析.结果 腹痛和血便是GIST常见临床表现;免疫组化CD117和CD34的阳性率分别为96.27%和81.36%;肿瘤直径和Fletcher分级在不同部位的GIST之间差异有统计学意义(P<0.05);术后1、3、5年生存率分别为90%、72%、67%;多因素分析显示Fletcher分级、术后辅助甲磺酸伊马替尼(IM)治疗是影响预后的独立危险因素.结论 腹痛和血便是GIST的常见临床表现;CD117和CD34是GIST诊断的常用病理指标;Fletcher分级有利于预后评判;靶向治疗能进一步改善预后.