【摘要】 目的分析中老年小肠间质瘤(small intestinal stromal tumor,SIST)的临床病理特征,为临床诊治提供经验。方法回顾性分析2010年1月至2016年10月南京医科大学第一附属医院收治的90例原发完全切除的中老年SIST病人的临床病理特征及术后随访资料。结果纳入90例SIST病人中,男53例(58.9%),女37例(41.1%),平均年龄(61.41±9.68)岁。肿瘤平均直径(5.72±3.05)cm,其中位于十二指肠36例(40.0%),空肠41例(45.6%),回肠13例(14.4%)。最常见的临床症状是消化道出血,共51例(56.7%)。危险度评估中,高度危险性33例(36.7%),中度危险性16例(17.6%),低度及极低度危险性33例(36.7%)。所有SIST病人接受完全切除手术,术后随访中,12例出现肿瘤复发,随访过程中无病人死亡。所有病人1年无复发生存率(relapse-free survival,RFS)为98.9%,3年RFS为95.7%,5年RFS为77.6%。结论 SIST好发于中老年人,临床表现各异,核分裂象、危险度是影响本组病人无复发生存的独立危险因素。更多还原

【Abstract】 Objective To analyze the clinicopathological features of primary small intestine stromal tumors( SIST) so as to provide experience for clinical diagnosis and treatment. Methods The clinicopathological features of 90 patients with primary SIST,which had been completely removed,were analyzed retrospectively from January 2010 to October 2016 in the First Affiliated Hospital of Nanjing Medical University. Results There were 53 males and 37 females among the 90 patients with SIST,with an average age of 61. 41 ± 9. 68 years. The average diameter of the tumor was 5. 72 ± 3. 05 cm.Among them,36 cases( 40. 0%) were located in duodenum,41 cases( 45. 6%) in jejunum and 13 cases( 14. 4%) in ileum. The most common clinical symptoms were gastrointestinal bleeding,with a total of 51 cases( 56. 7%). There were 33 cases( 36. 7%) with high risk,16 cases( 17. 6%) with moderate risk,33 cases( 36. 7%) with low and extremely low risk of the 90 patients. All patients with SIST underwent complete resection,and 12 patients relapsed,and no patients died during the follow-up. All patients had a 1-year relapse-free survival( RFS) of 98. 9%,a 3-year RFS of 95. 7% and a 5-year RFS of 76. 6%. Univariate prognostic analysis showed that tumor diameter( P = 0. 008),location( P =0. 018),mitosis( P<0. 001) and NIH risk grade( P = 0. 003) were associated with postoperative RFS.COX multivariate analysis showed that mitosis and NIH risk grade were independent risk factors of SIST( HR = 6. 733,95%CI: 2. 062-21. 989,P = 0. 002; RR = 7. 220,95%CI: 1. 554-33. 543,P = 0. 012).Conclusions Nuclear mitotic and NIH risk grade are independent risk factors of the prognosis.更多还原