Hong Liwen, Zhang Tianyu, Lin Yun, Fan Rong, Zhang Maochen, Cheng Mengmeng, Zhou Xiaolin, Sun Juntao, Sun Peijun, Wu Qiangqiang, Wang Lei, Wang Zhengting, Zhong Jie
Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Cadre Ward, Fujian Medical Union Hospital, Fujian, China.
Gastroenterol Res Pract. 2018 Feb 20;2018:4812703. doi: 10.1155/2018/4812703. eCollection 2018.
This study aims to analyze factors possibly related to the prognosis of duodenal gastrointestinal stromal tumors (DGISTs).
We collected and retrospectively analyzed clinical and pathological data of 62 patients with primary DGISTs. All the patients were hospitalized and received complete surgical resection at Shanghai Ruijin Hospital from September 2003 to April 2015. We followed up the patients to determine survival outcomes. We also analyzed the effect of clinical and pathological factors on disease-free survival (DFS) and overall survival (OS) of the patients.
Kaplan-Meier univariate survival analysis demonstrated that tumor size, mitotic index, Ki-67 index, and pathological risk were correlated with the DFS and OS of the patients (DFS = 0.039, 0.001, <0.001, and 0.005, resp.; OS = 0.027, 0.007, <0.001, and 0.012, resp.). Cox multivariate regression analysis revealed that Ki-67 index was an independent prognostic factor affecting DFS and OS ( = 0.007 and 0.028, resp.). Moreover, Kaplan-Meier survival analysis showed that imatinib treatment for patients with recurrence was correlated with prolonged OS ( = 0.002).
Prognosis for DGIST treated by R0 resection is favorable. High level of Ki-67 can be an independent risk factor of DGIST prognosis. Adjuvant imatinib therapy for patients with tumor recurrence could probably lead to prolonged survival.
本研究旨在分析可能与十二指肠胃肠道间质瘤(DGISTs)预后相关的因素。
我们收集并回顾性分析了62例原发性DGISTs患者的临床和病理数据。所有患者均于2003年9月至2015年4月在上海瑞金医院住院并接受了完整的手术切除。我们对患者进行随访以确定生存结局。我们还分析了临床和病理因素对患者无病生存期(DFS)和总生存期(OS)的影响。
Kaplan-Meier单因素生存分析表明,肿瘤大小、有丝分裂指数、Ki-67指数和病理风险与患者的DFS和OS相关(DFS分别为0.039、0.001、<0.001和0.005;OS分别为0.027、0.007、<0.001和0.012)。Cox多因素回归分析显示,Ki-67指数是影响DFS和OS的独立预后因素(分别为0.007和0.028)。此外,Kaplan-Meier生存分析表明,对复发患者进行伊马替尼治疗与延长OS相关(P = 0.002)。
通过R0切除治疗的DGIST预后良好。高水平的Ki-67可能是DGIST预后的独立危险因素。对肿瘤复发患者进行伊马替尼辅助治疗可能会延长生存期。