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[目的]探讨十二指肠胃肠间质瘤(GIST)的临床特征及其预后影响因素。[方法]收集整理2001年3月~2014年8月入我院普外科诊治的96例十二指肠GIST患者的病历资料,分析该病的临床特征及其预后影响因素。[结果]所有患者中以消化道出血和贫血为主要症状者34例(36.5%),以腹痛腹部不适为主要症状者36例(37.5%),平时无症状由体检发现者21例(20.8%);局限性手术治疗患者68例,胰十二指肠切除术患者28例;局限性手术所切肿瘤最大直径中位数为5(2~12)cm,胰十二指肠切除术所切肿瘤最大直径中位数为6(3~17)cm;NIH危险度分级:高危患者38例(39.6%),中危患者4例(4.2%),低于中危患者54例(56.2%);术后随访:术后1年、3年、5年总生存率分别为100%、98.5%、96.3%;无复发生存率分别为96.4%、91.2%、77.9%。Cox回归模型分析显示肿瘤最大直径≥5cm、核分裂像>5/50HPF、NIH分级为中危和高危都是影响该病预后的危险因素(P=0.010、0.000、0.047)。[结论]十二指肠GIST的临床症状不典型。肿瘤最大直径>5cm、核分裂像>5/50HPF以及NIH危险度分级达到中危和高危是影响着患者预后的危险因素。
[Objective] To investigate the clinical features and prognostic factors of gastrointestinal stromal tumors of the duodenum (GIST). [Method] The medical record data of 96 cases of duodenal GIST treated in our department from March 2001 to August 2014 were collected and analyzed, and the clinical features and prognostic factors were analyzed. [Results] Thirty-four patients (36.5%) had gastrointestinal bleeding and anemia as the main symptoms, 36 patients (37.5%) had abdominal pain and abdominal discomfort as the main symptoms, and 21 patients (20.8% ); Limited surgical treatment of 68 patients, pancreaticoduodenectomy in 28 patients; limited surgical resection of the tumor median diameter of 5 (2 ~ 12) cm, pancreatoduodenectomy cut The median tumor diameter was 6 (3-17) cm. The NIH risk grade was 38 (39.6%) in high-risk patients, 4 (4.2%) in intermediate-risk patients and 54 (56.2% ; Postoperative follow-up: The overall survival rates at 1 year, 3 years and 5 years after operation were 100%, 98.5% and 96.3% respectively. The recurrence-free survival rates were 96.4%, 91.2% and 77.9% respectively. Cox regression model analysis showed that the maximum tumor diameter ≥ 5cm, mitotic figures> 5 / 50HPF, NIH classification of the medium and high risk are the risk factors affecting the prognosis of the disease (P = 0.010,0.000,0.047). [Conclusion] The clinical symptoms of duodenal GIST are not typical. The maximum tumor diameter> 5cm, mitotic figures> 5 / 50HPF and NIH risk grade to reach the medium risk and high risk are the risk factors affecting the prognosis of patients.