胃间质瘤67例预后分析

目的探讨胃间质瘤的预后。方法回顾性分析1994~2004年67例胃间质瘤临床病理资料,以新的间质瘤分级法F lecther分级。采用kap lan-m e ier法绘制生存曲线(log-rank检验)和cox多因素回归分析对该组病例预后分析。结果根据F lecther风险分级,极低风险5例(7.5%),低风险11例(16.4%),中风险29例(43.3%),高风险22例(32.8%),术后生存率随分级依次递减(P=0.0001),比较肿瘤大小,核分裂相(>5,≤5),是否伴发远处转移,是否伴发淋巴结转移差异具有显著性(P<0.05),根治性手术与非根治性手术组比较差异具有显著性(P=0.04)。而肿瘤位置、年龄、性别、免疫组化表达情况、是否联合脏器切除差异无显著性。结论用F lecther分级对胃间质瘤分级评价更为科学合理。根治性手术是治疗胃间质瘤最佳选择,核分裂相是判断预后的独立预后因素。

The prognostic factor of Gastric Stromal Tumor:a study of 67 patients

Objective To investigate the prognostic factor of Gastric Stromal Tumors.Methods The clinicopathological data of oprated 67 patients with Gastric Stromal Tumors were analyzed restrospectively.Tumors were divided in risk classes using a new classification proposed by Flecther.kalian-meier survival rate curve and cox regression model were used to evaluate the prognostic factor.Results Using Flecther s classification,tumors were divided in very low risk(5/67,7.5%),low risk(11/67,16.4%),intermediate risk(29/67,43.3%),high risk(22/67,32.8%).The survival rate were gradually decreased from very low risk,low risk,intermediate,high risk(P=0.0001).Tumor size,mitosis,distant metastases,lymph node metastases were analyzed respectively,the difference is statistical significance(P<0.05).Compare complete surgical excision with incomplete excision,there is significant difference between this two group(P=0.04).No significant difference between the group of tumor location,age,sex,immunohistochemical expression,multi-organ excision or not.Conclusion Flecther s classification is scientific and rational.Complete surgical excision of the Gastric Stromal Tumors is the best chance of cure.Mitotic rate is an independent factor that may predict the prognosis of Gastric Stromal Tumors.