Zhang Wei, Ye Zai-yuan, Shao Qin-shu, Zhao Zhong-sheng, Wang Yue-dong, Xu Xiao-dong
Department of General Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2009 Jul;12(4):378-81.
To investigate the clinicopathological characteristics, surgical treatment and prognosis of gastrointestinal stromal tumors(GIST).
The clinicopathological data of 84 patients with GIST undergone resection between April 1997 and June 2008 were analyzed retrospectively, and the prognosis was evaluated.
Out of 84 cases, 42 tumors located in stomach, 24 in small intestine, 18 in other sites. Tumor sizes ranged from 0.5 to 25 cm(average 5.6 cm). Positive rate of CD117 expression determined by immunohistochemical methods was 96.4%. Seventy-nine cases underwent complete tumor resection, while 5 cases received palliative resection or biopsy. Seventy-eight patients were followed up and their 1-, 3-, 5-year survival rates were 92.0%, 79.2%, 72.0% respectively. The Fletcher's classification of malignancy risk groups for GIST was related to the survival rates(P=0.001). The differences of survival rate among very low risk group, low risk group and high-risk group were significant(P=0.003, P=0.000).
Complete tumor resection in the initial operation of GIST should be emphasized. The Fletcher's classification of malignancy risk groups for GIST is related to the survival rate. Extended surgical resection is required for GIST of higher malignancy risk.
探讨胃肠道间质瘤(GIST)的临床病理特征、手术治疗及预后。
回顾性分析1997年4月至2008年6月间84例行手术切除的GIST患者的临床病理资料,并评估其预后。
84例中,肿瘤位于胃42例,小肠24例,其他部位18例。肿瘤大小0.5~25cm(平均5.6cm)。免疫组化检测CD117表达阳性率为96.4%。79例行肿瘤完整切除,5例行姑息性切除或活检。78例患者获随访,其1年、3年、5年生存率分别为92.0%、79.2%、72.0%。GIST的Fletcher恶性风险分级与生存率相关(P=0.001)。极低风险组、低风险组和高风险组的生存率差异有统计学意义(P=0.003,P=0.000)。
GIST初次手术应强调肿瘤完整切除。GIST的Fletcher恶性风险分级与生存率相关。恶性风险较高的GIST需行扩大手术切除。