消化道间质瘤的临床病理特征及其与预后的相关性

目的 探讨消化道间质瘤临床病理特征及其与预后的关系.方法 选择2011年1月至2013年6月间我院收治的100例消化道间质瘤患者为研究对象,收集患者的性别、年龄、肿瘤大小、肿瘤部位、手术方式及肿瘤良恶性等临床资料.对手术标本及穿刺标本进行病理学检查及免疫组化检查.对所有患者进行随访,随访终止时间为患者死亡或随访满3年,采用Cox回归分析观察患者的临床资料、病理特征及其与预后的关系.结果 患者以年龄<60岁,肿瘤最大径5~10 cm者多见,发病部位以胃及小肠多见,肿瘤性质以恶性多见,主要采取局部切除治疗.病理特征以无出血坏死比例高,细胞类型以梭形细胞为主,轻度异型性,瘤细胞丰富,核分裂数>5/50 HPF多见.1年存活率为90%,复发率为12%,3年存活率为70%,复发率为28%.Cox多因素分析显示,肿瘤大小、手术方式、肿瘤性质、核分裂数、细胞类型、瘤细胞异型性是影响消化道间质瘤预后的重要因素.结论 消化道间质瘤具有自身的临床病理特征,其中肿瘤大小、手术方式、肿瘤性质、核分裂数、细胞类型、瘤细胞异型性是影响消化道间质瘤预后的重要因素.

Clinical pathological characteristics of gastrointestinal stromal tumors and its correlation with prognosis

Objective To investigate the clinicopathological characteristics of gastrointestinal stromal tumors and its relationship with prognosis. Methods One hundred patients of gastrointestinal stromal tumor treated from Janu-ary 2011 to June 2013 were selected as the research objects. The clinical data was collected, including gender, age, tumor size, tumor location, operation mode and the benign or malignant tumor. Pathological examination and immunohisto-chemical examination of surgical specimens and puncture specimens were carried out. All patients were followed up for 3 years or after death. Cox regression analysis was used to analyze the relationship between clinical data, pathological da-ta and prognosis. Results In patients with age<60 years, the tumors were mainly 5~10 cm in maximum tumor diame-ter, located in the gastric and small intestine, and were often malignant, which were commonly treated by local excision. Pathological characteristics of the rumors were dominated by non-hemorrhagic necrosis, and cells were mainly spindle cells, slightly abnormally-shaped, and rich in tumor cells, with number of nuclear division>5/50 HPF. The 1-year surviv-al rate was 90%, and recurrence rate was 12%. The 3-year survival rate was 70%, and recurrence rate was 28%. The tu-mor size, surgical approach, tumor nature, mitotic count, cell type, and cellular pleomorphism were the important factors influencing the prognosis of gastrointestinal stromal tumors. Conclusion Gastrointestinal stromal tumors has specific clinical and pathological characteristics, which tumor size, surgical approach, tumor nature, mitotic count, cell type, cel-lular pleomorphism are the important factors influencing the prognosis of gastrointestinal stromal tumor.