【摘要】 目的 ：本研究旨在分析2002—2016年上海市胃肠间质瘤（gastrointestinal stromal tumor,GIST）的发病情况和生存情况。方法 ：采用上海市疾病预防控制中心建立的人群基础肿瘤登记管理系统和死因登记系统收集的2002—2016年上海市胃肠间质瘤发病、死亡和随访资料，按诊断年份、性别、年龄组、病理组织学类型和诊断时期别等不同分类进行分层分析，计算例数、构成比、中位年龄和平均年龄等相关统计指标。应用寿命表法计算病例的1～5年观察生存率，应用Elandt-Johnson模型推算0～99岁逐岁的生存概率，再根据EdererⅡ方法计算期望生存率，最终获得病例的1～5年相对生存率。结果 ：2002—2016年上海市胃肠间质瘤新发病例2 148例，占所有消化系统恶性肿瘤病例的0.63%；中位年龄为63岁，平均年龄为（63.24±11.96）岁，男性与女性发病之比为0.89∶1；诊断时的期别中，Ⅰ期占10.66%、Ⅳ期占7.87%、期别不详占67.88%。按肿瘤部位分类，胃间质瘤最多（61.59%），其次是小肠间质瘤（25.05%）。胃肠间质瘤的病例数及其在所在部位恶性肿瘤中的占比均随时间呈增加趋势，其中2014—2016年胃间质瘤病例占所有胃癌病例的2.75%，小肠间质瘤病例占小肠恶性肿瘤病例的16.52%。2002—2013年上海市胃肠间质瘤病例的5年观察生存率为77.93%,5年相对生存率为85.16%，男性病例的各项生存率指标均低于女性。从病例的5年观察生存率和5年相对生存率来看，胃间质瘤病例的这2项生存率指标均高于小肠间质瘤病例，并且病例的生存率随诊断时期别的增加而降低。结论 ：上海市胃肠间质瘤诊断水平不断提高，但是病例生存率并没有随时间而提升。诊断时期别不详的病例所占比例较高，Ⅰ期病例所占比例较低且生存率没有提升。本研究为胃肠间质瘤的进一步研究以及预防和控制提供了依据。更多还原

【Abstract】 Objective:To investigate the incidences and survival rates of gastrointestinal stromal tumors (GISTs) in Shanghai from 2002 to 2016.Methods:Data on new GISTs and deaths with follow-up information from 2002 to 2016 were obtained from the population-based cancer registry and Vital Statistics System of Shanghai Municipal Center for Disease Control and Prevention.Incidences and survival rates were stratified by year of diagnosis,gender,age-group,histopathologic category and stage at diagnosis when analyzed.Number of cases,proportion,median age,mean age and other statistical indicators were calculated.The 1-to 5-year observed survival rates were calculated based on the life table.The probabilities of surviving from 0 to 99 years old were estimated with the Elandt-Johnson model,and then the cumulative expected survival rates were calculated with the Ederer Ⅱ method.Finally,the 1-to 5-year relative survival rates were calculated.Results:A total of 2 148 new GISTs cases were diagnosed from 2002 to 2016 in Shanghai,accounting for 0.63% of all malignant neoplasms of digestive organs.The median age and the mean age at diagnosis ware 63 years and 63.24±11.96 years,respectively.The ratio of males to females was 0.89:1.The proportions of stage I,stage IV and stage unknown were 10.66%,7.87% and 67.88%,respectively.Of all cases,61.59% were located in the stomach and 25.05% were located in small intestine.The number of cases and proportion in malignant neoplasms of the corresponding organs showed an increasing trend.From 2014 to 2016,gastric stromal tumors accounted for 2.75% of all stomach cancers,and small intestinal stromal tumors accounted for 16.52% of all malignant neoplasms of small intestine.The 5-year observed survival rate of GISTs diagnosed from 2002 to 2013 was 77.93% in Shanghai,and the 5-year relative survival rate was 85.16%.All survival rates of males were lower than those of females.The 5-year observed and relative survival rates of gastric stromal tumors were higher than those of small intestinal stromal tumors,and these survival rates decreased with the increase of stage at diagnosis.Conclusion:The diagnostic ability for GISTs has been improved continuously in Shanghai,but the survival rates have not been improved with time.The proportion of stage unknown was very high,and that of stage Ⅰ was low with no improvement in survival rate for a long time.This study has provided useful information for further research,control and prevention of GISTs.更多还原