对胃肠道间质瘤生物学行为的再评价

目的通过对106例胃肠道间质瘤（GIST）生物学行为的分类分析，试图找出更为全面的判断恶性行为的指标，为综合判断其预后提供更多依据。方法将106例GIST按肿瘤大小、高倍镜下核分裂相的多少及其发生的部位重新分类，按5年生存率进行单因素生存分析；同时对肿瘤的其他生物学行为进行单因素生存分析。结果GIST的恶性程度和预后不仅与肿瘤大小、50个高倍镜下有丝分裂数相、肿瘤的发生部位等密切相关；而且与肿瘤浸透黏膜（或浆膜）与否、合并坏死和（或）出血与否；有无腹腔、肝和（或）远处转移等密切相关；而与发病性别和年龄无关。结论对GIST生物学行为的判断不能仅依靠肿瘤大小；50个高倍镜下有丝分裂相及其发生部位等指标，应多因素分析并结合临床特点，必要时结合基因及其基因突变的检测来综合判断。

Re -evaluation of the biological behavior of gastrointestinal stromal tumor

Objective By classification analysis of biological behavior on 106 cases with gastrointestinal stromal tumor（GIST） , and to find a more comprehensive indicator of malignant behavior to determine, for the more comprehensive basis for judging the prognosis. Methods One hundred and six cases of GIST according to tumor size, high magnification, the number of mitotic figures and reclassified according to the site of occurrence of 5 - years survival rate in univariate survival analysis ; while the other biological behavior of tumor univariate survival analysis. Results Malignancy and prognosis of GIST was not only related with tumor size ; 50 high magnification the number of mitotic phase ; tumor closely related parts; and through the mucous membrane and tumor invasion （or） size film or not, with necrosis and （or） bleeding or not; whether the abdominal cavity, liver, and （or） was closely related to distant metastasis ; and with the onset of sex and age. Conclusions To determine the biological behavior of GIST can not rely solely on tumor size ; 50 high magnification mitotic index relative to other parts of its occurrence, should be combined with multi - factor analysis of clinical features and its gene mutations and gene comprehensive testing to determine.