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目的探讨影响胃肠道间质瘤(GIST)的预后因素。方法回顾性分析2000-2003年间41例GIST患者的免疫组织化学表达情况及肿瘤的大小、生长部位、核分裂数及手术的切除程度与该病预后的关系。结果GIST患者的病理切片中CD117、CD34和波形蛋白(vimentin)的表达比较高,分别为92.7%、82.9%和78.0%。生长在小肠的GIST比生长在胃和结直肠者预后差(P<0.05);肿瘤直径大于5cm患者的预后较小于或等于5cm的差(3年生存率为54%比72%,P<0.05);核分裂大于5/50HPF者预后较小于或等于5/50HPF者差(P<0.05);行不完全性切除手术者比行完全性切除者预后差(P<0.05)。结论完全性手术切除肿瘤能明显提高GIST患者的预后。生长在小肠的肿瘤、肿瘤直径大于5cm和核分裂大于5/50HPF是影响肿瘤预后的因素。
Objective To investigate the prognostic factors of gastrointestinal stromal tumors (GIST). Methods The immunohistochemical expression of 41 cases of GIST from 2000 to 2003 was analyzed retrospectively. The relationship among the tumor size, growth site, mitotic number and degree of resection was analyzed. Results The expression of CD117, CD34 and vimentin in pathological sections of GIST patients were higher than that of the other two groups (92.7%, 82.9% and 78.0% respectively). The prognosis of patients with tumors larger than 5 cm was less than or equal to 5 cm (3-year survival rate was 54% vs. 72%, P < 0.05). The prognosis was less than or equal to 5/50 HPF (P <0.05) when the mitotic score was more than 5/50 HPF. The prognosis of patients with incomplete mitotic surgery was worse than that of the complete resection (P <0.05). Conclusion Complete surgical resection of the tumor can significantly improve the prognosis of patients with GIST. Tumor growth in the small intestine, tumor diameter greater than 5cm and mitotic greater than 5 / 50HPF is a factor affecting tumor prognosis.