Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China.
Dalian Medical University, Dalian, People's Republic of China.
Medicine (Baltimore). 2022 Jun 24;101(25):e29487. doi: 10.1097/MD.0000000000029487.
We aim to assess factors that affect overall survival in patients with primary small intestinal gastrointestinal stromal tumors (GISTs) who had undergone R0 resection.
A retrospective analysis reviewed the data of 82 consecutive confirmed GIST patients at a single medical center in China from January 2012 to June 2020. The survival curve was estimated using the Kaplan-Meier method, and independent prognostic factors were confirmed using the Cox regression model.
A total of 82 patients were included in the study: 42 men and 40 women, the mean age was 59 years old (23-83 years old). Tumors were commonly found in the jejunum (46.3%), ileum (20.7%), and duodenum (32.9%). The median tumor size was 6.0 cm (range: 1.0-15.0 cm). The number of mitoses per one 50 high-power field was used to define the mitotic rates. In our present study, 56 patients presented a mitotic rate ≤5 (68.3%) and 26 patients showed a rate >5 (31.7%) at the time of diagnosis. All patients accepted tumor resection without lymph node resection. The positivity rate was 97.6% for CD117, 96.3% for delay of germination 1, 65.9% for CD34, 6.1% for S-100, and 59.8% for smooth muscle actin using immunohistochemistry. Tumor size, tumor rupture, Ki67 index, mitotic index, and postoperative imatinib were independent prognostic factors for small intestinal GISTs.
In this study, larger tumor size, high Ki67 index, high mitotic index, the occurrence of tumor rupture, and use of imatinib were independent unfavorable prognostic indicators.
本研究旨在评估行 R0 切除术的原发性小肠胃肠道间质瘤（GIST）患者的总生存相关因素。
回顾性分析了 2012 年 1 月至 2020 年 6 月在中国某单一医学中心确诊的 82 例连续 GIST 患者的数据。采用 Kaplan-Meier 法估计生存曲线，Cox 回归模型确定独立预后因素。
本研究共纳入 82 例患者：男 42 例，女 40 例，平均年龄 59 岁（23-83 岁）。肿瘤常见于空肠（46.3%）、回肠（20.7%）和十二指肠（32.9%）。肿瘤最大直径为 6.0cm（范围：1.0-15.0cm）。核分裂数/50 高倍镜视野用于定义核分裂率。在本研究中，56 例患者的核分裂率≤5（68.3%），26 例患者的核分裂率>5（31.7%）。所有患者均接受肿瘤切除术，未行淋巴结清扫术。免疫组织化学检测 CD117 阳性率为 97.6%，芽殖延迟 1 阳性率为 96.3%，CD34 阳性率为 65.9%，S-100 阳性率为 6.1%，平滑肌肌动蛋白阳性率为 59.8%。肿瘤大小、肿瘤破裂、Ki67 指数、核分裂指数和术后伊马替尼是小肠 GIST 的独立预后因素。
在本研究中，较大的肿瘤大小、较高的 Ki67 指数、较高的核分裂指数、肿瘤破裂的发生以及伊马替尼的使用是独立的不良预后指标。
