摘要
目的探讨初诊手术治疗胃肠间质瘤(GIST)的临床病理特征及预后因素。方法采用回顾性队列研究方法。收集2011年1月至2020年12月天津医科大学肿瘤医院收治的847例初诊手术治疗GIST患者的临床病理资料;男405例, 女442例;年龄为(60±10)岁。正态分布的计量资料以x±s表示, 组间比较采用t检验。偏态分布的计量资料以M(范围)表示。计数资料以绝对数或百分比表示, 组间比较采用χ^(2)检验。等级资料比较采用非参数秩和检验。采用Kaplan-Meier法计算生存率。单因素分析采用Log-rank检验, 多因素分析采用COX回归模型。结果 (1)GIST临床病理特征。847例患者中, 肿瘤原发部位为胃585例、空肠和回肠142例、十二指肠76例、结直肠10例、食管3例、胃肠道外31例;合并肝转移13例, 合并腹腔转移22例;肿瘤最大径为(7±5)cm, 核分裂象为4(0~60)个/50高倍视野或5 mm2;美国国立卫生研究院(NIH)危险度分级为极低危31例、低危238例、中危213例、高危365例。847例患者中, CD117阳性839例, Dog-1阳性788例, CD34阳性710例;272例Ki-67指数<5%, 214例为5%~9%, 198例为≥10%, 163例未知;R0切除814例, 非R0切除33例。(2)GIST患者基因检测与术后辅助治疗。①基因检测情况:847例患者中, 424例行基因检测, 其中2011年、2012年、2013年、2014年、2015年、2016年、2017年、2018年、2019年、2020年基因检测率分别为1.89%(1/53)、9.76%(8/82)、8.45%(6/71)、15.66%(13/83)、50.00%(40/80)、55.26%(42/76)、73.86%(65/88)、68.27%(71/104)、80.65%(75/93)、88.03%(103/117)。424例行基因检测患者中, KIT突变338例, PDGFRA突变31例, 野生型55例。②辅助治疗情况:847例患者中, 253例行术后辅助治疗, 其中低、中、高危患者术后辅助治疗的比例分别为8.82%(21/238)、41.78%(89/213)、39.18%(143/365)。578例中高危患者中, 2011年、2012年、2013年、2014年、2015年、2016年、2017年、2018年、2019年、2020年术后辅助
Objective To investigate the clinicopathological characteristics and prognostic factors of gastrointestinal stromal tumor(GIST)with initial surgical resection.Methods The retro-spective cohort study was conducted.The clinicopathological data of 847 GIST patients who under-went initial surgical resection in Tianjin Medical University Cancer Institute&Hospital from January 2011 to December 2020 were collected.There were 405 males and 442 females,aged(60±10)years.Measurement data with normal distribution were represented as Mean+SD,and comparison between groups was conducted using the t test.Measurement data with skewed distribution were represented as M(range).Count data were described as absolute numbers or percentages,and comparison between groups was conducted using the chi-square test.Comparison of ordinal data was conducted using the nonparameter rank sum test.The Kaplan-Meier method was used to calculate survival rates.Univariate analysis was conducted using the Log-rank test.Multivariate analysis was conducted using the COX regression model.Results(1)Clinicopatholo-gical characteristics.Of 847 patients,the tumor primary location was stomach in 585 cases,jejunum and ileum in 142 cases,duodenum in 76 cases,colorectum in 10 cases,esophagus in 3 cases,and extra-gastrointestinal in 31 cases.There were 13 cases with liver metastasis and 22 cases with abdominal metastasis.The tumor maximum diameter was(7±5)cm,and the number of nuclear divisions was 4(range,0-60)cells/50 high-power field or 5 mm^(2).According to risk classification of National Institutes of Health(NIH),31 cases were of extremely low risk,238 cases were of low risk,213 cases were of moderate risk,365 cases were of high risk.There were 839 of 847 patients positive for CD117,788 cases positive for Dog-1,710 cases positive for CD34,respectively.There were 272 cases with Ki-67<5%,214 cases with Ki-67 of 5%-9%,198 cases with Ki-67≥10%,163 cases with missing data.R。resection was in 814 cases and non-R。resection was in 33 cases.(2)Gene testing and p
作者
王晓娜
曹景新
王宝贵
詹宏杰
刘勇
丁学伟
刘宁
张汝鹏
梁寒
Wang Xiaona;Cao Jingxin;Wang Baogui;Zhan Hongjie;Liu Yong;Ding Xuewei;Liu Ning;Zhang Rupeng;Liang Han(Department of Gastric Oncology,Tianjin Medical University Cancer Institute&Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy of Tianjin,Tianjin's Clinical Research Center for Cancer,Tianjin 300060,China;Department of General Surgery,Tianjin Dongli Hospital,Tianjin 300301,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2024年第8期1080-1086,共7页
Chinese Journal of Digestive Surgery
基金
天津市医学重点学科建设项目(TJYXZDXK-009A)。
关键词
胃肠道间质瘤
手术
临床
病理
无复发生存率
预后
Gastrointestinal stromal tumor
Surgery
Clinical
Pathology
Pecurrence-free suirvivalrate
Prognosis
