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目的探讨胃肠间质瘤(GIST)的治疗及影响预后的因素。方法回顾性分析2001年1月至2007年12月天津医科大学附属肿瘤医院收治的经手术治疗的172例GIST病人的临床病理资料,并比较不同因素对预后的影响。结果153例获随访病人1、3、5年存活率分别为96.0%、82.6%、60.5%。单因素分析显示,肿瘤大小、肿瘤完整切除、核分裂像数目、肿瘤侵犯其他脏器、伴发转移、Fletcher分级和口服甲磺酸伊马替尼,对存活率有影响(P<0.05);多因素分析显示,伴发转移、Fletcher分级和口服甲磺酸伊马替尼是预后的独立影响因素(P<0.05)。结论伴发转移是影响预后的独立危险因素,同时Fletcher分级是判断GIST生物学行为及预后简单有效的方法,手术是治疗GIST的主要方法,靶向治疗能进一步改善GIST的预后。
Objective To investigate the treatment of gastrointestinal stromal tumors (GIST) and prognostic factors. Methods The clinical and pathological data of 172 surgically-treated GIST patients admitted to the Tumor Hospital Affiliated to Tianjin Medical University from January 2001 to December 2007 were retrospectively analyzed. The effects of different factors on the prognosis were compared. Results The survival rates at 1, 3 and 5 years of the 153 patients were 96.0%, 82.6% and 60.5% respectively. Univariate analysis showed that the size of the tumor, complete resection of the tumor, number of mitoses, tumor invasion of other organs, associated metastasis, Fletcher grade and oral imatinib mesylate had an effect on the survival rate (P <0.05); Factor analysis showed that the associated metastasis, Fletcher grade and oral imatinib mesylate were independent prognostic factors (P <0.05). Conclusions Concomitant metastasis is an independent risk factor for prognosis. Fletcher classification is a simple and effective method to judge the biological behavior and prognosis of GIST. Surgery is the main method of treatment for GIST. Targeted therapy can further improve the prognosis of GIST.