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349例胃肠道间质瘤的预后影响因素分析
Prognostic Analysis of 349 Cases with Gastrointestinal Stromal Tumor
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摘要: 目的 探讨影响胃肠道间质瘤(GIST)预后的因素。 方法 回顾性分析我院2006年1月至2011年9月收治的349例GIST患者的病例资料,并分析影响其预后的因素。 结果 335例患者行肿瘤完整切除术,14例行姑息切除术。288例(82.5%)获得随访,随访3~72月(中位时间33月),61例复发或转移,其中33例死亡。非条件logistic回归示:肿瘤部位(P=0.003,OR=1.412,95%CI:1.125~1.772)、危险度分级(P=0.011,OR=2.930,95%CI:1.278~6.716)、术后服用伊马替尼(P=0.009,OR=0.291,95%CI:0.115~0.734)是影响GIST患者术后复发或转移的独立因素。2006年至2008年期间128例患者Cox回归示:直径(P=0.034,OR=2.328,95%CI:1.065~5.089)、危险度分级(P=0.015,OR=3.031,95%CI:1.236~7.428)及术后服用伊马替尼(P=0.011,OR=0.259,95%CI:0.091~0.734)是影响术后3年生存率的独立因素。 结论 GIST缺乏特异性临床表现。肿瘤部位、直径、危险度分级均可影响预后。中高危患者术后口服伊马替尼可改善其预后。Abstract: Objective To investigate the prognostic factors of gastrointestinal stromal tumor(GIST). Methods Clinical data of 349 cases of GIST patients in our hospital between January 2006 and September 2011 were analyzed retrospectively and the prognostic factors were evaluated. Results 335 patients underwent R0 resection and 14 with palliative resection. With a follow-up of 288 (82.5%) patients (median:33 months, range 3-72 months), 61 patients with progressed were observed and 33 of them died. Unconditional logistic regression analysis showed that tumor location (P=0.003, OR=1.412, 95%CI:1.125-1.772), risk classification (P=0.011, OR=2.930, 95%CI:1.278-6.716) and use of imatinib treatment (P=0.009, OR=0.291, 95%CI:0.115-0.734) were independent factors for post-operative recurrence or metastasis. Survival analysis of 128 patients between January 2006 and December 2008, Cox regression analysis demonstrated diameter (P=0.034, OR=2.328, 95%CI:1.065-5.089), risk classification (P=0.015, OR=3.031, 95%CI:1.236-7.428) and use of imatinib treatment (P=0.011, OR=0.259, 95%CI:0.091-0.734) were independent prognosis factors. Conclusions No specific clinical manifestation was observed for GIST. Tumor location, diameter, risk classification and imatinib treatment could influence on prognosis. Radical resection combined with imatinib treatment could improve the prognosis.
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Keywords:
- Gastrointestinal stromal tumor /
- Clinical characteristics /
- Prognosis /
- Imatinib
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