摘要
目的探讨胃间质瘤临床病理特征及与预后相关的因素。方法收集中国医学科学院肿瘤医院1986年3月至2001年12月收治的98例有完整资料的位于胃的间质瘤、平滑肌瘤、平滑肌肉瘤、平滑肌母细胞瘤、许旺细胞瘤和神经纤维瘤患者的临床和病理资料，复阅切片（苏木精．伊红染色）、重新诊断，肿瘤两点取材构建组织微阵列；免疫组织化学染色检测CD117、CD34、平滑肌肌动蛋白（SMA）、desmin、S-100及Ⅺ．67蛋白等6种抗体的表达；单因素及多因素分析各变量与患者预后的关系。结果确诊间质瘤91例（92．9％）。随访率91．0％，中位随访时间54个月，患者1、5、10年生存率分别为88．8％、79．6％和63．7％。单因素分析显示，患者的预后与肿瘤大小、核分裂像数目、肿瘤坏死、核异型、细胞类型、细胞密集程度、手术类型、黏膜侵犯、年龄及Ki-67标记指数（5％为界）等因素有关（P〈0．05，P〈0．01）；多因素分析显示，肿瘤大小、核分裂像数目、肿瘤坏死及黏膜受侵是影响预后的重要因素（P〈0．05，P〈0．01）。结论肿瘤直径大于10cm、核分裂像数目超过10个／50HPF、肿瘤有坏死。黏膜受侵常提示胃间质瘤恶性度较高。
Objective To identify the clinicalpathological characteristics and prognostic factors in patients with gastrointestinal stromal tumors of the stomach. Methods The data of 98 patients of gastric stromal tumors, leiomyomas, leiomyosarcomas, leiomyoblastomas, schwannomas and neurofibromas, collected from Mar. 1983 to Dec. 2001 in our hospital with complete clinical and pathological data, were investigated retrospectively. Gastric stromal tumors were diagnosed by reviewing the tumor slides stained with hematoxylin and eosin （H＆E）. Two histomorphologically representative areas of each tumor slides were identified and arrayed on a tissue microarray. Immunohistochemistry staining were performed using antibodies to c-kit （CDl17）, CD34, smooth muscle actin（SMA）, Desmin and S-100 proteins. The relations of various clinicopathologic characteristics and outcomes were tested by univariate analysis and multivariate analysis. Results Ninty-one patients were clearly identified as gastric stromal tumors from the 98 patients, who were diagnosed as gastric stromal tumor,leiomyoma, leiomyosarcoma, leiomyoblastoma schwannoma and neurofibroma（92.9%）.The follow-up rate was 91% and the median follow up time was 54 months. The patient survival rates at 1,5 and 10 years were 88.8% ,79.6% and 63.7% respectively. Univariate analysis showed that tumor size, mitotic count, tumor necrosis, nuclear pleomorphism, cell type, cell density, surgical procedure,mucosal invasion, age and lable index of Ki-67 were associated with prognosis （P〈0.05）. Multivariate analysis showed that tumor size, mitotic count, mucosal invasion and tumor necrosis were predictors of prognosis （P〈 0.05）. Conclusion Tumor size of 〉10 cm, mitotic count of 〉10 mitoses per 50 high power fields, necrosis and mucosal invasion are often associated with an aggressive clinical course in gastric stromal tumors.
出处
《中华胃肠外科杂志》
CAS
2007年第1期21-25,共5页
Chinese Journal of Gastrointestinal Surgery
关键词
胃间质瘤
免疫组织化学
预后
Gastric stromal tumor
Immunohistochemistry
Prognosis
