CAJ | 학술논문

目的：总结胃肠道间质瘤（GIST）的病理及临床特点及其外科治疗和预后。方法回顾性分析我院术后病理证实的160例GIST患者的临床资料，其中随访145例，对其临床特点、病理特点、免疫标志物多因素进行预后的分析。结果160例行外科根治切除术患者，术中、术后均无死亡病例。生存的单因素分析病理特点显示，肿瘤的核分裂象、有无转移与Fletcher分级在胃肠间质瘤间差异有统计学意义（P＜0．05）；分析免疫组化 KIA、CD133免疫因子的阳性率分别为97．6％和81．3％。对生存预后有统计学意义（P＜0．05）。术后随访145例（91．25％），其中53例多发肝转移患者，术后均进行甲磺酸伊马替尼（400 mg／d）药物治疗，疗效显著（P＜0．05），多因素回归分析显示，Fletcher分级、甲磺酸伊马替尼是影响预后的独立危险因素。结论 Fletcher分级是评估GIST预后的有效手段，GIST患者采用外科根治性切除术联合甲磺酸伊马替尼治疗对原病灶、转移病灶治疗，其疗效显著。
목적：총결위장도간질류（GIST）적병리급림상특점급기외과치료화예후。방법회고성분석아원술후병리증실적160례GIST환자적림상자료，기중수방145례，대기림상특점、병리특점、면역표지물다인소진행예후적분석。결과160례행외과근치절제술환자，술중、술후균무사망병례。생존적단인소분석병리특점현시，종류적핵분렬상、유무전이여Fletcher분급재위장간질류간차이유통계학의의（P＜0．05）；분석면역조화 KIA、CD133면역인자적양성솔분별위97．6％화81．3％。대생존예후유통계학의의（P＜0．05）。술후수방145례（91．25％），기중53례다발간전이환자，술후균진행갑광산이마체니（400 mg／d）약물치료，료효현저（P＜0．05），다인소회귀분석현시，Fletcher분급、갑광산이마체니시영향예후적독립위험인소。결론 Fletcher분급시평고GIST예후적유효수단，GIST환자채용외과근치성절제술연합갑광산이마체니치료대원병조、전이병조치료，기료효현저。
Objective To study the clinicalpathological characteristics,surgical treatment andprognosis of the gastrointestinal stromal tumor(GIST).Methods The clinical data of 160 cases of pathologically confirmed GIST were retrospectively reviewed.Clinical features,pathological characteristics andimmune markers were studied by multiple factor analysis.Results There were no intraoperative or deathsin 140 patients who underwent radical resection.Univariate analysis of survival revealed significant differences in the main tumor pathological characteristics,including mitotic figure and metastasis and Fletcher'sclassification(P <0.05).Immunohistochemical results showed that the positive rates of KIA and CD133were 97.6% and 81.3% respectively,and their influences to survival prognosis were of statistical significance(P <0.05).A total of 145(90.6%)patients finished the follow up and 53 cases of them had multiple liver metastasis.These patients received imatinib mesylate(400 mg/d)and the efficacy was significant(P <0.05).Multivariate regression analysis showed that Fletcher's classification and imatinib mesylatewere the independent risk factors affecting prognosis.Conclusion Fletcher's classification is an effectivemethod for evaluating the prognosis of GIST.Radical resection and imatinib mesylate can reach a remarkable curative effect in treating original and metastatic lesions of the GIST patients.