胃的胃肠道间质合并胃癌患者的临床病理特点及预后影响分析.pdfVIP

胃的胃肠道间质瘤合并胃癌患者的临床病理特点及预后影响因素 中文摘要 目的 探讨胃的胃肠道间质瘤（GIST）合并胃癌患者的临床病理特点及预后 影响因素。方法 总结 2000 年 4 月至 2010 年 6 月期间施行外科手术治疗的 122 例原发性胃GIST患者的临床病理资料，其中胃GIST合并胃癌患者（合并组）26 例，胃 GIST 无合并胃癌患者（无合并组）96 例。探讨胃 GIST 合并胃癌患者中 间质瘤的临床病理特点，比较分析两组患者的预后差异，对全组患者的预后影响 因素进行单因素及多因素分析，对影响患者预后的独立因素进行分层分析。结果 合并组患者中胃 GIST 的最大直径小于无合并组，核分裂像数少于无合并组， Fletcher危险度分级低于无合并组，二组差异均有明显统计学意义（P0.05）。 全组患者的术后5年生存率为74.4%，胃GIST合并胃癌患者和胃GIST无合并胃 癌患者的术后 5 年生存率分别为 58.0%、79.4%，两组差异具有统计学意义 （P0.05）。单因素分析显示，肿瘤最大直径、核分裂像、Fletcher危险度分级、 是否合并胃癌是影响患者预后的相关因素；其中 Fletcher 危险度分级、是否合 并胃癌是影响全组患者预后的独立因素(P0.05)。对全组患者的 Fletcher 分级 进行分层分析显示，无论是在极低危/低危、中危，还是高危患者中，胃 GIST 合并胃癌患者的术后 5 年生存率均明显低于胃 GIST 无合并胃癌患者，差异具有 统计学意义（P0.05）。结论 胃 GIST 合并胃癌患者中，间质瘤的恶性危险度较 低，Fletcher 分级大多为极低或低侵袭危险性；这些患者的预后较差，应主要 针对胃癌进行治疗。 [关键词] 胃肠道间质瘤；合并胃癌；Fletcher分级；预后 1 Clinicopathologic features and prognostic impact of gastric gastrointestinal stromal tumors occurring synchronously with gastric cancer Abstract Objective To evaluated the clinicopathologic features and prognostic impact of gastric gastrointestinal stromal tumors occurring synchronously with gastric cancer.Methods The clinicopathologic date of 122 patients with gastric gastrointestinal stromal tumors who underwent surgical treatment from January 2000 to December 2010 were analyzed retrospectively.Twenty-six patients presented with gastric cancer con- currence(combined group),while 96 patients did not （ no-combined group).The clinicopathologic features of gastric GIST in combined group were studied.The 5-year survival rates were compared between two groups and between patients with different Fletcher classification in the combined group.Potential patient prognostic factors were evaluated by univariate and multivariate analyses.The independent prognostic factors of patients were performed su