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目的分析胃肠道间质瘤(gastro intestinal strom al tumors,G IST)的手术治疗效果及其影响复发和生存的因素。方法回顾1999年1月至2005年1月我院外科手术治疗的32例G IST患者的临床资料、病理诊断、免疫组织化学表达情况及手术过程并加以随访,分析手术治疗的效果及影响术后复发和生存率的因素。结果肿瘤直径<5 cm、≥5 cm、≥10 cm的复发率分别为0、20%、44.4%(P<0.05),全组中位生存时间为60.2个月,术后3年和5年生存率分别为70.6%和53.0%。肿瘤直径<5 cm患者的3年生存率显著高于≥5 cm者(P<0.05),复发组3年生存率显著低于未复发组(P<0.01),CD34阳性与阴性组患者的3年生存率差异无统计学意义(P>0.05)。结论G IST的预后与肿瘤大小、手术范围、手术的无瘤原则有密切关系。手术是G IST的首要治疗手段,可根据术中冷冻切片报告和肿瘤大小决定切除范围,免疫表型不能作为G IST的预后因素。
Objective To analyze the surgical treatment of gastrointestinal stromal tumors (G IST) and its influencing factors of recurrence and survival. Methods The clinical data, pathological diagnosis, immunohistochemical expression and surgical procedure of 32 patients with G IST undergoing surgical treatment in our hospital from January 1999 to January 2005 were retrospectively reviewed and analyzed. The effect of the operation and the effect of the operation were analyzed Recurrence and survival factors. Results The recurrence rates were 0,20% and 44.4% respectively (P <0.05), the median survival time was 60.2 months, 3 years and 5 years after operation Survival rates were 70.6% and 53.0% respectively. The 3-year survival rate of patients with tumor diameter <5 cm was significantly higher than that of ≥ 5 cm (P <0.05), and the 3-year survival rate of patients with recurrence was significantly lower than that of patients without recurrence (P <0.01) There was no significant difference in annual survival rate (P> 0.05). Conclusion The prognosis of GST is closely related to the tumor size, the scope of surgery and the principle of tumor-free surgery. Surgery is the primary treatment for G IST. The extent of resection can be determined by intraoperative frozen section reporting and tumor size. Immunophenotype can not be used as a prognostic factor for G IST.