小肠间质瘤术后复发影响因素分析：基于单中心数据的研究

摘要

目的：探讨影响小肠间质瘤（gastrointestinal stromal tumor ，GIST ）复发的高危因素。方法：回顾性分析2004年1月至2013年12月复旦大学附属中山医院收治的67例小肠GIST复发患者的临床资料。采用Kaplan‐Meier法分析不同因素对小肠GIST复发时间的影响；采用Cox多因素回归分析法分析小肠GIST 复发的独立影响因素。结果：单因素分析发现：肿瘤直径＞10 cm、核分裂象≥30个／50 HPF（高倍视野）、肿瘤破裂以及R0切除患者的中位复发时间明显缩短，差异有统计学意义（P＜0．05）；多因素分析发现：肿瘤破裂、手术方式是小肠GIST 复发的独立影响因素（P＜0．05）。结论：R0切除、术中避免肿瘤破裂可延长小肠GIS T的复发时间。%Objective:To investigate the recurrence factors of small intestine gastrointestinal stromal tumor (GIST ) after resection .Methods :The clinicopathological data of 67 patients with recurrent small intestine GIST admitted to Zhongshan Hospital affiliated to Fudan University from January 2004 to December 2013 were retrospectively analyzed .Kaplan‐Meier method was used to analyze the effects of different factors on the recurrence time of small intestine GIST .Cox multi‐factor regression analysis was used to analyze the independent factors of recurrence of small intestine GIST .Results :Univariate analysis revealed that the median recurrence time significantly shortened in patients with tumor diameter more than 10 cm , mitotic rate greater than or equal to 30/50 HPF ,tumor rupture ,and R0 resection ,and the difference was significant (P<0 .05) .Multivariate analysis demonstrated that tumor rupture and surgical methods were independent prognostic factors for the recurrence of small intestine GIST (P< 0 .05) .Conclusions :R0 resection and intraoperative tumor rupture avoidance can prolong the recurrence time of small intestine GIST .