117例胃肠道间质瘤的预后影响因素分析

目的探讨胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的预后影响因素及术后靶向治疗对预后的影响。方法回顾性分析中国医学科学院肿瘤医院2000年1月至2010年5月以手术为首次治疗方式的117例GIST病例的临床特点、影响预后的因素及术后靶向治疗对预后的影响。结果本组117例患者1,3,5年无病生存率分别为(96.1±1.9)%、(85.2±3.7)%、(80.1±4.2)%,中位生存期28个月。单纯手术组80例,复发21例,死亡20例,带瘤生存1例;手术联合靶向治疗37例,复发3例,死亡3例。结论发病部位、核分裂像和危险度分级是GIST患者预后的独立影响因素(P<0.05),术后辅助靶向治疗能够延长GIST患者无病生存期(P<0.05)。

Analysis of factors influencing prognosis of 117 cases of gastrointestinal stromal tumors

Objective To investigate the factors influencing prognosis of gastrointestinal stromal tumors（GIST）and the clinical efficacy of the postoperative targeted therapy.Methods The clinical data of 117 GIST patients between January 2000 and May 2010 were analyzed retrospectively,and the prognostic factors were evaluated.Results The 1-,3-and 5-year survival rates were（96.1±1.9）%,（85.2±3.7）%,（80.1±4.2）% respectively.Median survival time was 28 months.Eighty cases received operation only,37 cases received postoperative targeted therapy.Twenty-four cases were diagnosed as initial recurrence-metastasis after a median time of 12 months from primary resection.Conclusions The univariate analysis revealed that tumor location,mitotic count（per 50 HPF）and the risk strata were related to the overall survival（OS）（P0.05）,the postoperative targeted therapy was related to the disease free survival（P0.05）.Operation and postoperative targeted therapy improves disease free survival.