胃肠道间质瘤预后的多因素分析
摘要
目的:探讨胃肠道间质瘤的临床特点和预后相关因素的关系。方法:对75例胃肠道间质瘤的临床病理资料进行回顾性分析,并进行随访。数据先采用单因素筛选后,应用COX比例风险模型进行多因素分析。结果:胃肠道间质瘤好发于中年人,以胃多发,单因素分析显示,其预后在年龄、性别、族别、术前不适期、术前症状和术前贫血等方面差异无统计学意义(χ~2=0.781,0.001,0.829,0.572,0.736,0.559,P>0.05);而在部位、肿瘤直径、手术方式、术中浸润转移、分期、分级、术后服药、复发转移方面差异有统计学意义(χ~2= 6.507,6.618,23.084,22.278,17.146,12.761,9.491,3.362,P<0.05)。多因素分析显示:肿瘤直径、术中浸润转移方面差异有统计学意义(χ~2=8.999,4.571,P<0.05)。结论:肿瘤直径、术中浸润转移是影响GIST患者预后的独立影响因素。肿瘤的部位、手术方式、分期、分级、术后服药、复发转移也是评价预后的重要指标。手术完整切除依然是有效的治疗方法。
Objective:To explore the clinical characteristics as prognostic factors in patients with gastro-intestinal stromal tumors(GISTs). Methods:Clinical data of 75 patients of GISTs were retrospectively analyzed. COX Proportional Hazard Model(CPHM) was used in multivariate analysis. Results:Gastrointestinal stromal tumors occurred more frequently in middle-aged and most of them located in the gastritis. Age, gender, nationality, pre-operative discomfort, preoperative symptoms and preoperative anemia were no statistical significance for prognosis(χ~2=0.781,0.001,0.829,0.572,0.736,0.559,P>0.05). The diameter of the tumor, surgery, during the invasion and metastasis, staging, grading, postoperative medication, the transfer of recurrence significantly(χ~2= 6.507,6.618,23.084,22.278,17.146,12.761,9.491,3.362,P<0.05). A diameter of the tumor, during the invasion and metastasis prognosis of patients were independent prognostic factors based on a multivariate analysis of COX Proportional Hazard Model(CPHM). Conclusions:Tumor diameter, during the invasion and metastasis prognosis of patients with GIST is an important factor. The tumor site, operative, staging, grading, postoperative medication, is also the evaluation of recurrence and metastasis prognosis. Complete surgical excision is still an effective treatment.
Objective:To explore the clinical characteristics as prognostic factors in patients with gastro-intestinal stromal tumors(GISTs). Methods:Clinical data of 75 patients of GISTs were retrospectively analyzed. COX Proportional Hazard Model(CPHM) was used in multivariate analysis. Results:Gastrointestinal stromal tumors occurred more frequently in middle-aged and most of them located in the gastritis. Age, gender, nationality, pre-operative discomfort, preoperative symptoms and preoperative anemia were no statistical significance for prognosis(χ~2=0.781,0.001,0.829,0.572,0.736,0.559,P>0.05). The diameter of the tumor, surgery, during the invasion and metastasis, staging, grading, postoperative medication, the transfer of recurrence significantly(χ~2= 6.507,6.618,23.084,22.278,17.146,12.761,9.491,3.362,P<0.05). A diameter of the tumor, during the invasion and metastasis prognosis of patients were independent prognostic factors based on a multivariate analysis of COX Proportional Hazard Model(CPHM). Conclusions:Tumor diameter, during the invasion and metastasis prognosis of patients with GIST is an important factor. The tumor site, operative, staging, grading, postoperative medication, is also the evaluation of recurrence and metastasis prognosis. Complete surgical excision is still an effective treatment.
引文
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[13]余剑波,姚光飞.31例胃肠间质瘤临床分析.肿瘤学杂志2007.13 (3):235-23.
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[17] Pierie J P, Choudry U, Muzikansky A, et al. The effect of surgery and grade on. Outcome of gastrointestinal stromal tumors [J]. Arch Surg,2001, 136: 383 - 389
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[19] Tuveson DA, Willis NA, Jacks T, et al. STI571 inactivation of the gastrointestinal stromal tumor c - KIT oncoprotein: Biological and clinical imp lications. Oncogene, 2001, 20(36):5054
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[24] Connolly EM, Gaffney E, Reynolds JV. Gastrointestinal stromal tumors [J] .Br J Surg, 2003, 90: 1178- 1186.
[25] Emory TS, Sobin LH, Lukes L, et al. Prognosis of gastrointestinal smooth muscle (stromal) tumors: dependence on anatomic site [J]. Am Clin Pathol, 1995, 154: 53-60.
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