31例胃小间质瘤临床特点及预后分析

黄振; 李原; 赵宏; 赵建军; 蔡建强

doi:10.3969/j.issn.1000-8179.2013.12.012

31例胃小间质瘤临床特点及预后分析

Prognostic factors and clinicopathological characteristics of small gastrointestinal stromal tumor of the stomach: A retrospective study of 31 cases

摘要

摘要:
目的探讨原发于胃的小间质瘤的临床病理特点和预后影响因素。
方法回顾性分析1999年3月~2012年3月期间在中国医学科学院肿瘤医院接受手术治疗并经病理证实的31例胃小间质瘤的临床资料, 统计临床特点并分析影响其预后的因素。
结果 31例患者中29例获得随访(随访率93.5%)。其中男性10例, 女性21例, 中位年龄58(37~81)岁。腹部不适和腹痛是最主要的首发症状(各10例, 32.3%)。全组患者均接受手术治疗, 胃大部切除和胃壁局部切除各11例, 腹腔镜下胃壁局部切除5例, 胃镜下肿瘤剥离4例, 术后无重大并发症。截止到随访终点, 肿瘤复发2例, 肝转移1例; 因肿瘤进展死亡1例, 因其他恶性肿瘤死亡1例。中位总生存时间(OS)预测值为130.4个月, 中位无疾病进展时间(PFS)预测值为120.3个月。
结论胃小间质瘤总体预后较好; 手术切除是主要治疗方式, 可根据情况选取微创治疗方式; 肿瘤坏死、出血和胃黏膜受累可能是预后不良因素。

Abstract:
Objective The present study aimed to analyze the clinicopathological characteristics and prognostic factors of small gastrointestinal stromal tumors(GISTs) of the stomach.
Methods A total of 31 small gastric GIST patients, 10 males and 21 females, with a median age of 58 years old(37~81 years), who underwent surgery at any time from 1999 to 2012 were included in this study.The clinical records of the patients were analyzed retrospectively.
Results Abdominal discomfort and pain(10 cases, 32.3%, respectively) were the two most common complaints among the patients.All patients received surgery, 11 received gastric wedge resection, 11 received subtotal gastroectomy, 5 received laparoscopic gastric wedge resection, and 4 received endoscopic submucosal dissection.No severe adverse complication was observed.A total of 29 patients(93.5%) were followed up.During the follow-up, 2 patients were found to exhibit tumor recurrence, and 1 patient had liver metastases.One patient died of tumor progression, while another died of another malignant tumor.Median progression-free survival(PFS) time was 120.3 months, and median overall survival(OS) time was 130.4 months.
Conclusion Small gastric GISTs have better prognosis.Surgery is the best choice for therapy.Micro-invasive procedures are safe and effective for elective patients.Tumor necrosis, tumor bleeding, and muscle invasion are potential prognostic factors of small gastric GISTs.

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