胃间质瘤132例预后分析

目的 探讨胃间质瘤患者生存情况以及手术治疗和药物治疗对患者生存的影响.方法 回顾性分析2003年1月至2013年1月具有完整病理及随访资料的132例原发胃间质瘤患者的临床特点及生存情况.结果 132例患者术后中位随访22个月（1～83个月）,1、3、5年的生存率分别为99％、96％、92％.肿瘤位于贲门19例（14.4％）,胃底34例（25.8％）,胃大弯38例（28.8％）,胃小弯38例（28.8％）,胃窦3例（2.3％）.其中CD117＋116例（87.9％）,CD34＋119例（90.2％）,Ki-67＋ 51例（38.6％）.按照Fletcher分级,极低生物学风险者10例（7.6％）,低风险者34例（25.8％）,中风险者14例（10.6％）,高风险者74例（56.1％）.Fletcher风险分级极低风险患者的1、3、5年生存率均为100％,低风险患者均为97％,中风险患者均为92％,高风险患者分别为96％、88％、83％,差异有统计学意义（P=0.028）.完全切除＋伊马替尼组患者1、3、5年生存率均为100％,完全切除未服用伊马替尼组患者均为99％,非完全切除＋伊马替尼组患者分别为89％、65％、48％,差异有统计学意义（P＜0.05）;不同解剖分区的胃间质瘤患者生存率差异无统计学意义（P＞0.05）.结论 不同解剖部位的胃间质瘤患者预后无明显不同,手术完整切除肿瘤和术后服用伊马替尼可改善患者预后.

Prognotic analysis of 132 cases with gastrointestinal stromal tumors

Objective　To analyze the survival rates of gastrointestinal stromal tumors (GISTs), and the influence of surgical treatment and imatinib to the survival times. Methods　The clinical data of 132 patients with GIST who were admitted to Peoples Liberation Army Hospital from January 2003 to December 2013 were retrospectively analyzed. Results　All the patients were followed up with a median time of 22 months (1-83 months). The survival rates of 1-year, 3-year, 5-year were 99 %, 96 %, 92 % in this study. The tumor located at cardiac part, fundus of stomach,greater curvature, lesser curvature and pylorus part was 19 cases (14.4 %), 34 cases (25.8 %), 38 cases (28.8 %), 38 cases (28.8 %) and 3 cases (2.3 %), respectively. The positive rates of CD117, CD34 and Ki-67 was 116 cases (87.9 %), 119 cases (90.2 %), 51 cases (38.6 %). According to Fletcher risk classification, the patients of high-low risk, low risk,intermediate risk, and high risk were 10 cases (7.6 %), 34 cases (25.8 %), 14 cases (10.6 %), and 74 cases (56.1 %), respectively. The differences of survive rates in the different excision method and imatinib treatment had statistics significance (P = 0.000). The differences of survive rates in Fletcher risk classification had statistics significance (P = 0.028). However, the differences of survive rates in location of gastric GIST showed no significant difference (P > 0.05). Conclusions　GIST in different parts of gastric have not obviously different survival rates, respectively. The total resection and imatinib treatment could raise the survival rates of patients with GIST.