胃肠道间质瘤的预后分析

背景：目前普遍认为胃肠道间质瘤（GIST）并不是绝对良性。近年多项研究评估了GIST的预后因素．但其中多数研究未考虑当前GIST的定义。目的：探讨不同因素对GIST预后的影响。方法：回顾性研究华东医院2001年1月．2006年12月间的22例接受完整手术切除的GIST患者的临床和病理资料（含免疫组化检查），并进行随访，分析肿瘤大小、核分裂象、性别、年龄和原发部位与GIST预后的关系。结果：本组患者平均随访26个月，1年、2年和5年无复发生存率分别为77％、64％和42％。不同肿瘤大小和不同核分裂象组间GIST患者的无复发生存时间差异有统计学意义（P〈0．01）。Cox回归分析显示无复发生存时间与性别、年龄和肿瘤原发部位无关。胃GIST与非胃GIST的复发率无明显差异。结论：肿瘤大小、核分裂象是GIST的预后因素，肿瘤直径≥2cm或核分裂5／50HPF的GIST患者应加强随访。

Pronostic Analysis of Gastrointestinal stromal Tumor

Background： Many gastrointestinal stromal tumors （GIST） have an uncertain malignancy potential. Recently, prognostic factors of GIST have been appraised in several studies, however, most of them have not considered the current definition of GIST. Aims： To appraise the effect of different factors on the prognosis of GIST. Methods： Clinical and pathological data （including immunohistochemistry） of 22 GIST patients underwent complete surgical resection from January 2001 to December 2006 in Huadong Hospital were reviewed retrospectively. GIST patients were followed-up, the relationship between tumor size, mitotic count, gender, age, tumor location and prognosis of GIST was analyzed. Results： With a median follow-up of 26 months, recurrence-free survival rate was 77%, 64% and 42% at 1, 2 and 5 years, respectively. Significant differences of recurrence-free survival time were found in GIST patients with different tumor size and with mitotic count （P〈0.01）. Cox regression analysis showed that gender, age and tumor location were not independent prognostic factors of recurrence-free survival time. Tumors arising from the stomach have similar recurrence rate as compared with those from small bowel, mesentery, omentum, colon or rectum. Conclusions： Tumor size and mitotic count are prognostic factors of GIST. Patients with tumor size≥2 cm or mitotic count≥5/50 HPF should be carefully followed-up.