CAJ | 학술논문

目的探讨结直肠间质瘤的临床表现、组织学、免疫组化特点、外科处理和预后.＃方法对30例结直肠间质瘤患者的临床及病理学资料进行回顾性分析,按Fletcher肿瘤侵袭危险度评估分级将其分为极低度恶性、低度恶性、中度恶性、高度恶性四组,并用Cox多因素回归分析评估患者预后影响因素. 结果结直肠间质瘤发生在结肠4例(13%),直肠20例(67%),肛管6例(20%).免疫组化C-kit阳性表达率为87%.30例结直肠间质瘤全部行手术切除.29例(97%)获术后随访,随访时间4～130个月.3年生存率为73%,5年生存率为53%.Fletcher侵袭危险度评估分级与患者预后密切相关(B=4.226,P=0.02).结论外科手术联合分子靶向治疗是结直肠间质瘤的最有效治疗手段,Fletcher侵袭危险度评估分级对具体术式的选择及患者预后有重要意义.
목적 탐토결직장간질류적림상표현、조직학、면역조화특점、외과처리화예후.＃방법대30례결직장간질류환자적림상급병이학자료진행회고성분석,안Fletcher종류침습위험도평고분급장기분위겁저도악성、저도악성、중도악성、고도악성사조,병용Cox다인소회귀분석평고환자예후영향인소. 결과결직장간질류발생재결장4례(13%),직장20례(67%),항관6례(20%).면역조화C-kit양성표체솔위87%.30례결직장간질류전부행수술절제.29례(97%)획술후수방,수방시간4～130개월.3년생존솔위73%,5년생존솔위53%.Fletcher침습위험도평고분급여환자예후밀절상관(B=4.226,P=0.02).결론 외과수술연합분자파향치료시결직장간질류적최유효치료수단,Fletcher침습위험도평고분급대구체술식적선택급환자예후유중요의의.
Objective To analyze clinical manifestations, histology, immunohistochemistry (IHC), surgical treatment and prognosis of colorectal stromal tumours. Methods The clinical and pathological data of 30 cases of colorectal stromal tumors were analyzed retrospectively. According to Fletcher proposed approach for defining risk group in GIST, these cases were grouped into VLR, LR, IR and HR.Cox multiple regression multiple factor analysis method was used to evaluate impact factors for prognosis.Results Radical resection was achieved in all 30 cases. Tumors located in the colon in 4 ( 13% ) cases, in the rectum in 20 (67%) cases, and within the anal canal in 6 (20%) cases. C-kit expression was positive in 86. 7% cases as determined by IHC. Postoperatively, 29 cases were followed-up from 4 to 130 mos. The Fletcher proposed approach for defining risk group in GIST was closely related to the survival rates ( B =4. 226,P =0. 02). The 3- and 5-year survival rate was 73% and 53% respectively. Conclusions Surgical resection and molecular target treatment is the treatment of choice for colorectal stromal tumors. The Fletcher's classification of malignancy risk group for colorectal stromal tumors is statistically related to the modus operandi and patients' survival rate.