摘要
目的:分析原发胃肠间质瘤(GIST)的临床病理特征及预后情况。方法:回顾分析中南大学湘雅医院2012年1月—2018年8月期间诊治的314例原发GIST患者的临床病理及随访资料。结果:314例GIST患者中,男性169例(53.8%),女性145例(46.2%),其中位年龄为55(24～86)岁,肿瘤直径为6(1～34)cm;原发部位位于胃165例(52.6%)、十二指肠15例(4.8%)、空回肠115例(36.6%)、结直肠6例(1.9%)、其他部位13例(4.1%)。根据改良NIH分级,其中极低危11例(3.5%)、低危109例(34.7%)、中危80例(25.5%)、高危114例(36.3%)。314例均接受手术治疗,其中R_0切除305例(97.1%)、R_1切除4例(1.3%)、R_2切除5例(1.6%)。268例(85.4%)获得有效随访,中位随访时间为37(2～69)个月。194例中高危患者中67例(34.5%)术后接受伊马替尼辅助治疗,中位治疗时间为26(7～56)个月。全组1、3、5年总体无复发生存率为97.0%、92.6%、81.7%,1、3、5年总体总存活率为99.4%、95.2%、88.2%。极低危、低危、中危及高危患者其5年无复发存活率分别为100.0%、93.3%、79.1%、64.4%,5年总存活率分别为100.0%、94.1%、91.7%、74.9%。194例中高危GIST患者中,67例术后接受伊马替尼辅助治疗者及127例术后未接受伊马替尼辅助治疗者5年无复发存活率分别为73.8%、65.2%,5年总存活率分别为87.5%、71.6%。结论:原发GIST最常见发病部位是胃和小肠,完整切除并根据危险度分级予以伊马替尼辅助治疗预后较好,但还需针对不同的高危GIST患者量身定制个体化治疗方案,并且在规范辅助治疗的同时,还需严密系统地随访。
Objective:To analyze clinicopathologic features and prognosis of primary gastrointestinal stromal tumor(GIST).Methods:The clinicopathologic and follow-up data of 314 patients with primary GIST treated in Xiangya Hospital of Central South University from January 2012 to August 2018 were retrospectively analyzed.Results:Of the 314 GIST patients,169 cases(53.8%)were males and 145 cases were(46.2%)females,with a median age of 55(24-86)years and a median tumor diameter of 6(1-34)cm;the primary site located in the stomach in 165 cases(52.6%),duodenum in 15 cases(4.8%),jejunum or ileum in 115 cases(36.6%),colorectum in 6 cases(1.9%),and other sites in 13 cases(4.1%).According to the modifi ed NIH classifi cation,the diseases of the patients were classifi ed as very low risk in 11 cases(3.5%),low risk in 109 cases(34.7%),moderate risk in 80 cases(25.5%),and high risk in 114 cases(36.3%).All the 314 patients underwent surgical treatments,of whom,305 cases(97.1%)achieved R0 resection,4 cases(1.3%)received R1 resection,and 5 cases(1.6%)had R2 resection.Followed-up was obtained in 268 patients(85.4%)for a median time of 37(2–69)months.Of the 194 patients with moderate or high risk disease,67 cases(34.5%)received imatinib-based adjuvant therapy aft er operation,with a median time of 26(7–56)months.In the whole group of patients,the 1-,3-and 5-year relapsefree survival rates were 97.0%,92.6%and 81.7%,and the 1-,3-and 5-year overall survival rates were 99.4%,95.2%and 88.2%,respectively.In patients with very low risk,low risk,moderate risk and high risk disease,the 5-year relapse-free survival rates were 100.0%,93.3%,79.1%and 64.4%,and the 5-year overall survival rates were 100.0%,94.1%,91.7%and 74.9%,respectively.Among the 194 patients with moderate or high risk disease,the 5-year relapse-free survival rates in the 67 cases with postoperative imatinib adjuvant therapy and the 127 cases without postoperative imatinib adjuvant therapy were 73.8%and 65.2%,and the 5-year overall survival rates were 87.5%and 71.6%,respectively.C
作者
赵丁民
廖国庆
刘盛
漆靖
朱从波
刘苇行
蔡高强
ZHAO Dingmin;LIAO Guoqing;LIU Sheng;QI Jing;ZHU Congbo;LIU Weihang;CAI Gaoqiang(Department of Gastrointestinal Surgery,Xiangya Hospital,Central South University,Changsha 410008,China)
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2019年第4期467-473,共7页
China Journal of General Surgery
基金
湖南省自然科学基金资助项目(2017JJ2380)
关键词
胃肠道间质肿瘤
外科手术
化学疗法
辅助
预后
Gastrointestinal Stromal Tumors
Surgical Procedures,Operative
Chemotherapy,Adjuvant
Prognosis
