摘要
目的:观察腹腔镜切除术联合伊马替尼治疗胃肠道间质瘤的临床疗效,探讨影响预后的因素。方法:选取2008年1月至2012年5月在医院治疗的胃肠道间质瘤患者70例,随机分成两组,研究组35例和对照组35例。研究组患者采用腹腔镜切除术后给予伊马替尼400mg/次,1次/d;对照组患者只采用腹腔镜切除术治疗。对两组患者的生存率与复发率进行随访统计,并分析影响预后的因素。结果:研究组和对照组患者1年无复发,生存率分别为100%和82.9%。2年无复发,生存率分别为94.3%和62.9%。术后使用伊马替尼辅助治疗能明显延长患者无复发生存时间。中危患者中,两组无复发,生存率无明显异常;高危患者中,研究组2例(5.7%)出现复发转移,对照组有13例(37.1%)出现肿瘤复发转移,两组无复发、生存率差异显著。危险度、肿瘤大小、有丝分裂数和伊马替尼辅助治疗是影响预后的独立性因素。结论:腹腔镜切除术联合伊马替尼治疗中危或高危胃肠道间质瘤患者能显著改善预后,提高其无复发生存率,治疗效果在高危患者中最为明显。
Objective:To observe clinical curative effect of gastrointestinal stromal tumor by laparoscopic resection plus imatinib,and discuss the factors influencing prognosis Methods:70cases of patients with gastrointestinal stromal tumor had been selected from January 2008 to May 2010 in the first hospital of Yangtze University,and randomly divided into two groups,35 cases in the study group and 35 cases in the control group.The patients in the study group had been treated with Imatinib 400mg/times,once a/d after laparoscopic resection.The patients in the control group had been treated by laparoscopic resection only.The survival rate and the recurrence rate in two groups were calculated in the follow-up visits,and factors affecting the prognosis had been analyzed.Results:One-year relapse-free survival rates in the study group and the control group were 100% and 82.9%respectively;two-year relapse-free survival rates were 94.3% and 95%.Postoperative use of Imatinib as adjuvant therapy could obviously prolong relapse-free survival in patients.There was no obvious difference in the relapse-free survival rate between moderate-risk patients of two groups.However as for high-risk patients,2cases(5.7%)of recurrence occurred in the study group,and 13cases(37.1%)in the control group;there was significant difference in the relapse-free survival rate between two groups.Risk,tumor size,number of mitosis and adjuvant therapy with imatinib were the independent factors affecting the prognosis.Conclusion:Laparoscopic resection with imatinib therapy can significantly improve prognosis in moderate-risk or high-risk patients with gastrointestinal stromal tumor;the relapse-free survival rate can be raised and the treatment effect is the most obvious in high-risk patients.
关键词
腹腔镜切除术
伊马替尼
胃肠道间质瘤
laparoscopic resection
imatinib
gastrointestinal stromal tumor
