胃的胃肠间质瘤复发因素及预后

目的 探讨胃的胃肠间质瘤（GIST）复发的相关因素及其预后.方法 回顾性总结1987年1月至2008年12月浙江省中西医结合医院收治的107例胃GIST患者的临床、病理及随访资料,并分析各变量因素与肿瘤复发的关系.结果 行根治性手术患者83例（根治组）,姑息性手术患者24例（姑息组）.随访6~246个月.根治组术后31例患者复发,复发与非复发患者比较,其肿瘤是否大于5 cm、肿瘤包膜完整与否及有无周围侵犯与肿瘤复发有关（P＜0.05） 而性别、年龄、肿瘤位置和核分裂与肿瘤复发无关（P＞0.05）.复发组患者中位生存期13个月,未复发组为78个月 两组生存率的比较差异有统计学意义（P＜0.05）.根治组患者中位生存期54（7～246）个月,姑息组则仅为6（1～25）个月,两组差异有统计学意义（P＜0.05）.结论 对于肿瘤大于5 cm、无完整包膜、有周围侵犯的胃GIST患者,应争取根治切除,警惕其复发.

Factors associated with recurrence and prognosis in patients with gastric gastrointestinal stromal tumors

Objective To investigate factors associated with postoperative recurrence and prognosis in gastric gastrointestinal stromal tumors(gastric GIST). Methods Clinical data of 107 patients with gastric GIST who underwent surgical resection at the Zhejiang Province Hospital of the Integrated Traditional Chinese and Western Medicine between January 1987 and December 2008 were analyzed retrospectively. Factors associated with recurrence were explored. Results Surgery was radical in 83 patients(radical group) and palliative in 24 patients(palliative group). Thirty-one patients developed recurrence in the radical group. Tumor size greater than 5 cm, incompleteness of tumor envelope, and local invasion were associated with tumor recurrence(P＜0.05), while gender, age, tumor location, and mitosis were not. The median survival time was 13 months in patients with recurrence and 78 month in those without recurrence, and the difference was statistically significant(P＜0.05). The median survival was 54(range, 7-246) months in the radical group and 6 (range, 1-25) in the palliative group, and the difference was also statistically significant(P＜0.05). Conclusion Tumor size, integrity of tumor envelope, and local invasion are predictive for recurrence in GIST.