CAJ | 학술논문

目的探讨影响胃肠道间质肿瘤(GIST)预后的因素.方法收集1999年11月至2006年12月于复旦大学附属华山医院住院手术治疗并经病理确诊为GIST的病例85例,回顾性分析性别、年龄、肿瘤部位、手术方式、首诊转移、淋巴结清扫及Flecther分级等因素对患者预后的影响.结果本组患者的1年、3年、5年生存率分别为94%、60%、57%.单因素分析显示,GIST患者的预后与肿瘤原发部位、手术方式、Fletcher分级(肿瘤大小和核分裂数)以及有无首诊转移有关(P＜0.05),而与性别、年龄及是否行淋巴结清扫无关.多因素分析显示,有无首诊转移是影响预后的独立因素(P=0.020,β=4.226).结论根治性手术仍然是目前原发GIST的首选治疗,首诊转移是影响预后的独立危险因素,故早期发现、早期诊断、早期手术治疗对GIST的预后显得尤为重要.同时,Fletcher分级也是评估GIST的有效而简便的方法之一.
목적 탐토영향위장도간질종류(GIST)예후적인소.방법 수집1999년11월지2006년12월우복단대학부속화산의원주원수술치료병경병리학진위GIST적병례85례,회고성분석성별、년령、종류부위、수술방식、수진전이、림파결청소급Flecther분급등인소대환자예후적영향.결과 본조환자적1년、3년、5년생존솔분별위94%、60%、57%.단인소분석현시,GIST환자적예후여종류원발부위、수술방식、Fletcher분급(종류대소화핵분렬수)이급유무수진전이유관(P＜0.05),이여성별、년령급시부행림파결청소무관.다인소분석현시,유무수진전이시영향예후적독립인소(P=0.020,β=4.226).결론 근치성수술잉연시목전원발GIST적수선치료,수진전이시영향예후적독립위험인소,고조기발현、조기진단、조기수술치료대GIST적예후현득우위중요.동시,Fletcher분급야시평고GIST적유효이간편적방법지일.
Objective To investigate the prognostic factors of gastrointestinal stromal tumors.Methods From Nov.1999 to Dec.2006,a total of 85 patients were diagnosed by postoperative pathology as gastrointestinal stromal tumors.The relationship between the prognosis of GIST and demographic factors、tumor location、operation style、preoperative metastasis、lymphadenectomy、grading of Fletcher were analyzed retrospectively.Results The 1 year、3 year and 5 year survival rate of these 85 patients were 94%,60%,57%respectively,Univariate analysis indicated that tumor location、operation style、grading of Fletcher and preoperative metastasis were significant predictors of survival(P<0.05),while demographics and lymphadenectomy were not statistically related with prognosis.Multivariate analysis showed that preoperative metastasis was the independent factor predicting the prognosis(P=0.020,β=4.226).Conclusion Radical surgical excision is still the therapy of choice for primary gastrointestinal stromal tumors.Preoperative metastasis is the independent factor predicting poor prognosis,therefore early diagnosis and treatment are very important for GIST.Fletcher grading is also a simple recalls to predict the prognosis of GIST.