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中国人群胃肠道间质瘤的临床病理特征及预后因素

Clinico-pathological characteristics and prognostic factors of gastrointestinal stromal tumors among a Chinese population.

作者信息

Li Jiehua, Zhang Haitian, Chen Zhibai, Su Ka

机构信息

Department of Gastrointestinal and Gland Surgery, The First Affiliated Hospital of Guangxi Medical University Nanning, Guangxi Province, China.

出版信息

Int J Clin Exp Pathol. 2015 Dec 1;8(12):15969-76. eCollection 2015.

Abstract

Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal tumors of the digestive tract. GISTs include a group of heterogeneous tumors with different morphology, biologic behavior, and genetic characteristics, so their epidemiology, clinico-pathological features and prognosis is distinct in different countries. The objective of this study is to analyze clinico-pathological characteristics and prognostic factors of GISTs among Chinese population. We investigated 112 GIST patients were diagnosed between July 2008 and January 2013 at the First Affiliated Hospital of Guangxi Medical University. Histologic evaluation and immunohistochemistry analysis was performed on paraffin-embedded tissue from the 112 GISTs. Overall survival analysis was carried out using the Kaplan-Meier method and the log-rank test. Multivariate analysis was performed according to Cox's proportional hazards model. Three and 5-year OS rates were 71.4 and 58.6% respectively. Univariate analysis showed that the following factors were significant in predicting OS: tumor site, tumor size, metastasis, resection margin status, cell type, invasion of adjacent organ, invasion of smooth muscle, mitotic rate, P53 and adjuvant therapy with imatinib (P<0.05). Multivariate analysis showed that tumor size, metastasis, resection margin status, mitotic rate, P53 and adjuvant therapy with imatinib were independent prognostic factors associated with OS. This may aid in the prediction of clinical evolution and guide treatments in patients with GIST in China.

摘要

胃肠道间质瘤(GISTs)是消化道最常见的原发性间充质肿瘤。GISTs包括一组形态、生物学行为和遗传特征各异的肿瘤,因此其流行病学、临床病理特征和预后在不同国家有所不同。本研究的目的是分析中国人群中GISTs的临床病理特征和预后因素。我们调查了2008年7月至2013年1月在广西医科大学第一附属医院确诊的112例GIST患者。对112例GISTs的石蜡包埋组织进行了组织学评估和免疫组化分析。采用Kaplan-Meier法和对数秩检验进行总生存分析。根据Cox比例风险模型进行多变量分析。3年和5年总生存率分别为71.4%和58.6%。单变量分析显示,以下因素在预测总生存方面具有显著性:肿瘤部位、肿瘤大小、转移、切缘状态、细胞类型、邻近器官侵犯、平滑肌侵犯、核分裂率、P53和伊马替尼辅助治疗(P<0.05)。多变量分析显示,肿瘤大小、转移、切缘状态、核分裂率、P53和伊马替尼辅助治疗是与总生存相关的独立预后因素。这可能有助于预测中国GIST患者的临床进展并指导治疗。

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