中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2012年
3期
263-265
,共3页
胃肠间质瘤,直肠%外科手术%肿瘤复发%肿瘤转移%预后
胃腸間質瘤,直腸%外科手術%腫瘤複髮%腫瘤轉移%預後
위장간질류,직장%외과수술%종류복발%종류전이%예후
Gastrointestinal stromal tumors,rectum%Surgical procedures%Tumor recurrence%Tumor metastasis%Prognosis
目的 探讨直肠胃肠间质瘤(GIST)的预后特点.方法 对新疆医科大学附属中医医院和天津市人民医院1979年6月至2010年6月间收治的40例直肠GIST患者的临床和随访资料进行回顾性分析.结果 40例直肠GIST中男性23例,女性17例,年龄28～81(中位数54.5)岁.术后随访1～300(中位52.5)个月,复发和转移18例,其中单纯局部复发7例,单纯远处转移6例,局部复发并远处转移5例.术后1、3及5年生存率分别为82.5％、60.0％及42.5％.单因素预后分析显示,患者术后生存率与肿瘤大小(P＜0.01)、肿瘤Fletcher分级(P＜0.01)、核分裂像(P＜0.01)及术后远处转移(P＜0.05)有关；多因素预后分析显示,肿瘤大小(P＜0.05)、核分裂像(P＜0.01)和术后远处转移(P＜0.01)是直肠GIST的独立预后因素.结论 直肠GIST治疗仍以手术切除为主,肿瘤原发灶大小、核分裂像和术后远处转移是影响预后的独立因素.
目的 探討直腸胃腸間質瘤(GIST)的預後特點.方法 對新疆醫科大學附屬中醫醫院和天津市人民醫院1979年6月至2010年6月間收治的40例直腸GIST患者的臨床和隨訪資料進行迴顧性分析.結果 40例直腸GIST中男性23例,女性17例,年齡28～81(中位數54.5)歲.術後隨訪1～300(中位52.5)箇月,複髮和轉移18例,其中單純跼部複髮7例,單純遠處轉移6例,跼部複髮併遠處轉移5例.術後1、3及5年生存率分彆為82.5％、60.0％及42.5％.單因素預後分析顯示,患者術後生存率與腫瘤大小(P＜0.01)、腫瘤Fletcher分級(P＜0.01)、覈分裂像(P＜0.01)及術後遠處轉移(P＜0.05)有關；多因素預後分析顯示,腫瘤大小(P＜0.05)、覈分裂像(P＜0.01)和術後遠處轉移(P＜0.01)是直腸GIST的獨立預後因素.結論 直腸GIST治療仍以手術切除為主,腫瘤原髮竈大小、覈分裂像和術後遠處轉移是影響預後的獨立因素.
목적 탐토직장위장간질류(GIST)적예후특점.방법 대신강의과대학부속중의의원화천진시인민의원1979년6월지2010년6월간수치적40례직장GIST환자적림상화수방자료진행회고성분석.결과 40례직장GIST중남성23례,녀성17례,년령28～81(중위수54.5)세.술후수방1～300(중위52.5)개월,복발화전이18례,기중단순국부복발7례,단순원처전이6례,국부복발병원처전이5례.술후1、3급5년생존솔분별위82.5％、60.0％급42.5％.단인소예후분석현시,환자술후생존솔여종류대소(P＜0.01)、종류Fletcher분급(P＜0.01)、핵분렬상(P＜0.01)급술후원처전이(P＜0.05)유관；다인소예후분석현시,종류대소(P＜0.05)、핵분렬상(P＜0.01)화술후원처전이(P＜0.01)시직장GIST적독립예후인소.결론 직장GIST치료잉이수술절제위주,종류원발조대소、핵분렬상화술후원처전이시영향예후적독립인소.
Objective To analyze the prognosis of rectal gastrointestinal stromal tumors (GIST).Methods Records of 40 patients diagnosed as rectal GIST at the Affiliated Chinese Traditional Medical Hospital of Xinjiang Medical University and the People's Hospital of Tianjin City between June 1979 and June 2010 were reviewed.Clinical features,treatment modalities and outcomes were analyzed.Results There were 23 males and 17 females with a median age of 54.5 years old (range,28-81 years old).During the follow-up (median 52.5 months,range 1-300 months),18 patients developed recurrence including 7 local recurrence,6 metastasis and 5 local recurrence complicated with metastasis.The overall survival rates at 1,3 and 5 years were 82.5％,60.0％,and 42.5％ respectively.On univariate analysis,tumor size (P＜0.01),Fletcher classification (P＜0.01),mitotic index (P＜0.01),and postoperative distant metastasis were associated with survival.Multivariate analysis showed that tumor size (P＜0.05),mitotic rate (P＜0.01),and postoperative distant metastasis (P＜0.01) were independent prognostic factors associated with survival.Conclusions Surgery is the main treatment for rectal GIST.Tumor size,mitotic rate and metastasis are independent prognostic factors in patients with rectal GIST.
