284例胃间质瘤临床特征及预后分析

目的总结胃间质瘤临床特征及治疗方式,分析影响预后的因素。方法回顾分析2010年8月至2015年12月收治的284例行胃间质瘤手术患者的临床资料,采用电话回访及门诊复查进行随访,随访时间截至2016年9月30日。统计分析使用SPSS17.0软件进行,绘制生存曲线采用Kaplan-Meier法,单因素分析临床病理特征与胃间质瘤患者预后关系采用Log-rank检验,P0.05为差异具有统计学意义。结果 284例患者,其中男性132例,女性152例;年龄27~84岁,中位年龄60岁,胃间质瘤直径0.2~20 cm,中位直径4 cm,268例患者行免疫组织化学检测,其中CD117阳性的98.51%(264/268),CD34阳性的97.76%(262/268);改良NIH危险度分级:极低危41例,低危114例,中危58例,高危62例。177例获得随访(随访率62.32%),中位随访时间31.7个月(9.5~71.3个月)。单因素分析结果显示:手术根治性切除、肿瘤直径、改良NIH危险度分级与患者术后预后有关(P0.05)。结论胃间质瘤是常见的腹腔间质瘤,外科治疗是主要措施,手术根治性切除、肿瘤直径和NIH危险度分级是影响胃间质瘤预后的主要因素,药物靶向治疗一定程度改善患者预后。

Clinical characteristics and prognostic analysis of gastric stromal tumor: report of 284 cases

Objective To summarize the clinical characteristics and treatment of gastric stromal tumors,and to analyze the prognostic factors.Methods Clinical data of 284 patients with gastric stromal tumor from August 2010 to December 2015 were analyzed retrospectively.All of 284 patients were followed up till September 30 2016 by telephone or out-patient re-examination.Statistical analysis was performed by using SPSS17.0 software,and survival rate was calculated by using the Kaplan-Meier method.The univariate analysis of the relationship between pathological characteristics and prognosis of patients were performed by using Log-rank test.A P value <0.05 was considered as statistically significant difference.Results Among 284 patients,there were 132 cases of male and 152 cases of female with median age of 60 year(ranging from 27 year to 84 year)and median tumor diameter of 4 cm(ranging from 0.2 cm to 20 cm).268 patients were examined by immunohistochemistry,The positive rates of CD117 and CD34 were 98.51％(264/268)and 97.76％(262/268)respectively.According to the modified NIH risk stratification,there were 41 cases of very low risk,114 cases of low risk,58 cases of moderate risk and 62 cases of high risk.177 patients were followed up with median time of 31.7 months(ranging from 9.5months to 71.3 months).The univariate analysis showed that radical resection,tumor diameter and modified NIH risk stratification were correlated with the survival rates of patients(P<0.05).Conclusions Gastric stromal tumor is a common abdominal stromal tumor,surgical operation is still the main treatment.Radical resection,tumor diameter and NIH risk classification are the main factors influencing the prognosis of gastric stromal tumor,while targeted therapy could improve the prognosis of patients.