【摘要】 目的探讨胃肠间质瘤(GIST)患者的病理特征及其与预后的相关性。方法选取我院2005年10月至2012年10月期间收治的120例行手术治疗并经病理证实的胃肠道间质瘤患者,回顾性分析患者的临床病理及随访资料,并通过单因素及多因素分析明确GIST患者的病理因素与预后的相关性。结果 GIST患者的病灶形态以类圆形居多,肿块无包膜或有假包膜,部分病灶边缘呈分叶状,病灶向浆膜外或消化腔内生长,少数病灶有囊性变、坏死、出血等形态改变;免疫组化结果显示,DOG1、CD117、CD34、IGFIR、Desmin、SMA、S-100的阳性表达率分别为96.67%(116/120)、95.00%(114/120)、80.00%(96/120)、5.83%(7/120)、3.33%(4/120)、45.00%(54/120)、6.67%(8/120);单因素分析结果显示,不同肿瘤大小、核分裂数目、NIH恶性危险度以及是否接受甲磺酸伊马替尼治疗患者的3年生存率比较差异均有统计学意义(P<0.05);多因素回归分析结果显示,核分裂数目、NIH危险度、肿瘤大小、甲磺酸伊马替尼治疗均是影响患者预后的独立因素(P<0.05)。结论 GIST患者的DOG1、CD117的阳性表达率较高,CD34、CD117为弥漫性阳性表达,S-100和SMA呈局灶性分布,核分裂数目、NIH危险度、肿瘤大小及甲磺酸伊马替尼治疗均是影响患者预后的独立因素。更多还原

【Abstract】 Objective To study the pathological features of gastrointestinal stromal tumors(GIST) and its correlation with prognosis. Methods A total of 120 cases of patients with GIST, who underwent surgical treatment in our hospital from October 2005 to October 2012, were selected as the study objects. The pathological and follow-up data of patients were retrospectively analyzed. Correlation between GIST pathological factors and prognosis of the patients was confirmed by the single factor and multi-factor analysis. Results The lesions of patients with GIST were most in the round, and the mass had no envelope or pseudo capsule. Some lesions were lobulated, and growth of lesions were to the outside of the film or in the digestive cavity. A few lesions had cystic change, necrosis, hemorrhage. Immunohistochemical results showed that the positive expression rates of DOG1, CD117, CD34, IGFIR, Desmin, SMA, and S-100 were respectively 96.67%(116/120), 95.00%(114/120), 80.00%(96/120), 5.83%(7/120), 3.33%(4/120), 45.00%(54/120),6.67%(8/120). Single factor analysis results showed there were significant differences in survival rates of different tumor size, number of nucleus division, NIH risk of malignant degree and whether to accept the mesylate for Nigeria in the treatment of patients with 3 years(P<0.05). Multivariate regression analysis showed that imatinib mesylate treatment,number of nucleus division, NIH risk of malignant degree were the independent influence factors of prognosis of patients(P<0.05). Conclusion The positive expression rates of DOG1 and CD117 are higher in patients with GIST.CD117 and CD34 are the diffuse positive expression, while S-100 and SMA show focal distribution. Imatinib mesylate therapy, tumor size, number of nucleus division, NIH risk of malignant degree are all the independent influence factors for the prognosis of patients.更多还原