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中华结直肠疾病电子杂志 ›› 2019, Vol. 08 ›› Issue (03) : 236 -240. doi: 10.3877/cma.j.issn.2095-3224.2019.03.005

所属专题: 文献

论著

胃肠道外间质瘤预后因素分析
郑国良1, 郑志超1,(), 赵岩1,()   
  1. 1. 沈阳 110042,中国医科大学肿瘤医院 辽宁省肿瘤医院胃外科
  • 收稿日期:2018-11-15 出版日期:2019-06-25
  • 通信作者: 郑志超, 赵岩

Prognostic factors of extragastrointestinal stromal tumors

Guoliang Zheng1, Zhichao Zheng1,(), Yan Zhao1,()   

  1. 1. The Gastric Surgery Department, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang 110042, China
  • Received:2018-11-15 Published:2019-06-25
  • Corresponding author: Zhichao Zheng, Yan Zhao
  • About author:
    Corresponding author: Zheng Zhichao, Email:
    Zhao Yan, Email:
引用本文:

郑国良, 郑志超, 赵岩. 胃肠道外间质瘤预后因素分析[J/OL]. 中华结直肠疾病电子杂志, 2019, 08(03): 236-240.

Guoliang Zheng, Zhichao Zheng, Yan Zhao. Prognostic factors of extragastrointestinal stromal tumors[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2019, 08(03): 236-240.

目的

探讨胃肠道外间质瘤(EGIST)的临床特征及影响预后的因素。

方法

回顾性分析2006年11月至2017年5月间辽宁省肿瘤医院收治的首次进行外科治疗且经病理证实的47例胃肠道外间质瘤患者的临床及随访资料,与本中心的254例胃肠间质瘤(GIST)患者资料进行对比。

结果

EGIST与GIST患者在年龄(χ2=6.394,P<0.011),肿瘤大小(χ2=60.941,P<0.001),组织学类型(χ2=30.081,P<0.001),CD117表达(χ2=52.99,P<0.001),CD34表达(χ2=37.21,P<0.001)、Dog-1表达(χ2=24.57,P<0.001),是否坏死(χ2=10.38,P=0.006)、改良NIH危险度分级(χ2=56.12,P<0.001)之间差异有统计学意义。EGIST患者1、2、3年生存率分别为84.6%、78.3%、63.4%;接受R0切除的EGIST患者25例(53.2%)。R0切除患者的生存率明显高于非R0切除患者(χ2=5.104,P=0.024)。其中,25例R0切除的患者中显示不同核分裂像、不同肿瘤直径大小、是否伴坏死与EGIST患者的预后未体现统计学意义(χ2=2.067,P=0.151;χ2=1.355,P=0.244;χ2=0.912,P=0.34)。

结论

EGIST患者症状隐匿,不易早诊断,首次就诊时肿瘤体积往往较大。是否R0切除关系到患者的预后。

Objective

To explore clinical features and prognostic factors of extragastrointestinal stromal tumors (EGIST).

Methods

The clinical and follow-up data of 47 patients with extragastrointestinal stromal tumors admitted to Liaoning Cancer Hospital for the first time from November 2006 to May 2017 were retrospectively analyzed, and compared with 254 cases of gastrointestinal stromal tumor (GIST) in our center.

Results

EGIST and GIST patients showed significant differences in age (χ2=6.394, P<0.011), tumor size (χ2=60.941, P<0.001), histological type (χ2=30.081, P<0.001), CD117 expression (χ2=52.99, P<0.001), CD34 expression (χ2=37.21, P<0.001), Dog-1 expression (χ2=24.57, P<0.001), necrosis (χ2=10.38, P=0.006), and NIH score (χ2=56.12, P<0.001). One year, two years and three years survival rates of all EGIST patients were 84.6%、78.3%、63.4% respectively; 25 patients(51.4%) were with R0 resection. The survival rate of patients with R0 resection was significantly higher than that of patients without R0 resection (χ2=5.104, P=0.024). Among them, the prognosis of 25 patients with R0 resection showed no statistical significance in patients with different mitotic figures, tumor diameters, necrosis (χ2=2.067, P=0.151; χ2=1.35, P=0.244; χ2=0.912, P=0.34).

Conclusion

EGIST symptoms are dormant and difficult to diagnose, with large volume at first. R0 resection is associated with prognosis.

表1 EGIST和GIST的临床病理参数比较(例)
图1 EGIST患者的总生存曲线
图2 EGIST患者肿瘤是否R0切除的生存曲线。注:χ2=5.104,P=0.024
图3 R0切除的EGIST患者肿瘤不同核分裂象的生存曲线。注:χ2=2.067,P=0.151
图4 R0切除的EGIST患者肿瘤不同大小的生存曲线。注:χ2=1.355,P=0.244
图5 R0切除的EGIST患者肿瘤有无坏死的生存曲线。注:χ2=0.912,P=0.34
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