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关于胃肠道间质瘤出血危险因素的多中心研究。

Multi-center study regarding the risk factors for bleeding in gastrointestinal stromal tumor.

作者信息

Park Kyung Sik, Huh Kyu Chan, Hwang Ilseon, Kwon Jung Hyeok, Kwon Joong Goo, Kim Gwang Ha, Shin Jeong Eun, Kim Eun Soo, Cho Kwang Bum

机构信息

Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.

出版信息

Hepatogastroenterology. 2013 Mar-Apr;60(122):235-9. doi: 10.5754/hge12622.

Abstract

BACKGROUNDS/AIMS: In spite of several case reports about gastrointestinal stromal tumor (GIST) complicated with hemorrhage, study regarding the risk factors of bleeding in this tumor is scanty. Therefore, we analyzed the clinical characteristics of bled GISTs and tried to find risk factors of bleeding by comparing with non-bled cases.

METHODOLOGY

Medical records of 49 bled GIST cases from 5 university hospitals in Korea between year 2001 to 2010 were compared with 96 non-bled cases. Whole pathological slides were reviewed by an experienced pathologist.

RESULTS

Female predominance (58.6%) was noted and the mean age of the included patients was 58.4±13.1 years. In univariate analysis, location of jejunum, prolonged prothrombin time, presence of surface dimpling in CT, cellular pleomorphism and positivity of S100 was significantly dominant in the bled cases. Multivariate analysis showed significant differences in the location of jejunum (p=0.004, OR=3.533), prolonged prothrombin time (p=0003, OR=19.643), presence of surface dimpling (p=0.026, OR=6.250) in CT, and positivity of S100 (p=0.001, OR=12.941).

CONCLUSIONS

Location of jejunum, prolonged prothrombin time, presence of surface dimpling in CT, and positivity of S100 are independent risk factors associated with bleeding in GI GIST patients.

摘要

背景/目的:尽管有几例关于胃肠道间质瘤(GIST)合并出血的病例报告,但关于该肿瘤出血危险因素的研究却很少。因此,我们分析了出血性GIST的临床特征,并通过与未出血病例比较试图找出出血的危险因素。

方法

将2001年至2010年间韩国5所大学医院的49例出血性GIST病例的病历与96例未出血病例进行比较。由一位经验丰富的病理学家复查全部病理切片。

结果

发现女性占优势(58.6%),纳入患者的平均年龄为58.4±13.1岁。在单因素分析中,空肠部位、凝血酶原时间延长、CT表现为表面凹陷、细胞多形性以及S100阳性在出血病例中显著占优。多因素分析显示空肠部位(p = 0.004,OR = 3.533)、凝血酶原时间延长(p = 0.003,OR = 19.643)、CT表现为表面凹陷(p = 0.026,OR = 6.250)以及S100阳性(p = 0.001,OR = 12.941)存在显著差异。

结论

空肠部位、凝血酶原时间延长、CT表现为表面凹陷以及S100阳性是胃肠道GIST患者出血的独立危险因素。

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