小肠间质瘤临床、影像及病理学特征与预后的相关性分析

目的:分析小肠间质瘤临床、影像及病理学特征与术后转移复发和死亡的相关性。方法:回顾性分析2013年01月至2016年12月北京友谊医院及北京市房山区良乡医院普外科收治的经手术治疗且病理检查确诊的61例小肠间质瘤患者，术后对其进行为期3年的随访。观察指标包括患者的临床特征、影像学特征、临床病理特征以及预后情况。结果:单因素分析结果提示，小肠间质瘤患者术后复发或转移与肿瘤直径、CT肿瘤密度不均匀改变、核分裂象计数、是否浸润、改良NIH危险度分级、切除分级、是否服用伊马替尼相关；小肠间质瘤患者术后死亡与年龄、肿瘤直径、核分裂象计数、是否浸润、改良NIH危险度分级和切除分级相关。多因素分析提示肿瘤直径>5 cm和核分裂象＞5/50高倍镜视野是小肠间质瘤患者复发或转移的独立危险因素；肿瘤直径>5 cm和改良NIH危险度中高危组是小肠间质瘤患者死亡的独立危险因素。结论:肿瘤大小、核分裂象计数以及改良NIH危险度分级是影响小肠间质瘤患者预后的独立相关因素。

Correlation analysis of clinical,imaging and pathological features with prognosis of small intestinal stromal tumor

Objective:To analyze the correlation of clinical,imaging and pathological features of small intestinal stromal tumor (SIST) with postoperative metastasis/recurrence and death.Methods:Clinical data of 61 patients with SIST confirmed by surgical and pathological examination from Jan. 2013 to Dec. 2016 in department of general surgery,Beijing Friendship Hospital and Liangxiang Hospital were retrospectively collected and analyzed.Three-year follow-up was performed for the patients.The observational parameters included clinical characteristics,imaging features,clinicopathological features,and prognosis.Results:Univariate analyses revealed that postoperative recurrence or metastasis in SIST patients was related to tumor diameter,heterogeneous density,mitotic count,infiltration,modified NIH risk classification,resection classification and whether imatinib was taken.Postoperative mortality was related to age,tumor diameter,mitotic count,infiltration,modified NIH risk classification,and resection classification.Multivariate analyses suggested that tumor diameter >5 cm and mitotic count >5/50 high power field were independent risk factors for relapse or metastasis in SIST patients and tumor diameter >5 cm and intermediate and high risk groups according to the modified NIH risk classification criteria were independent risk factors for death of SIST patients.Conclusion:Larger tumor size,higher mitotic counts and intermediate- and high-risk tumors based on modified NIH risk classification criteria are independent risk factors that affect the prognosis of SIST patients.