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目的分析胃肠间质瘤(GIST)临床病理特点、两种术式围术期效果及预后。方法以2010年1月至2012年12月收治的120例胃肠间质瘤患者为研究对象,对其术前检查、治疗方法、治疗效果、临床病理特点、随访结果等相关资料进行整理分析,观察GIST临床病理特点、腹腔镜与开腹手术围术期效果及预后影响因素。结果腹腔镜组20例术中出血量、术后排气时间、活动恢复时间及住院时间明显少于开腹手术组30例(P均<0.01)。GIST类型:梭形细胞型88例,上皮样细胞型21例,混合型11例。CD117阳性114例,CD34阳性94例,DOG1阳性117例(其中弱阳性23例,中阳性46例,强阳性48例)。Logistic回归分析影响GIST患者预后独立危险因素为肿瘤转移及危险分级(P<0.05,P<0.01)。结论 DOG1、CD117、CD34可作为GIST诊断的重要免疫组化指标。腹腔镜手术相比传统开腹手术具有创伤小、术后恢复快特点。GIST危险分级及肿瘤转移与患者预后密切相关。
Objective To analyze the clinicopathological characteristics of gastrointestinal stromal tumors (GIST), the perioperative effects and prognosis of the two surgical procedures. Methods From January 2010 to December 2012, 120 patients with gastrointestinal stromal tumors were enrolled in this study. The preoperative examination, treatment, treatment, clinicopathological features, follow-up results and other related data were analyzed. To observe the clinicopathological characteristics of GIST, the perioperative effect of laparoscopy and laparotomy and prognostic factors. Results In the laparoscopic group, 20 cases of intraoperative bleeding, postoperative exhaust time, activity recovery time and hospitalization time were significantly less than those in the laparotomy group (P <0.01). GIST type: spindle cell type in 88 cases, epithelioid cell type in 21 cases, mixed type in 11 cases. There were 114 cases of CD117 positive, 94 cases of CD34 positive and 117 cases of DOG1 positive (including 23 cases of weakly positive, 46 cases of positive and 48 cases of strongly positive). Logistic regression analysis showed that independent prognostic risk factors for GIST were tumor metastasis and risk grade (P <0.05, P <0.01). Conclusion DOG1, CD117 and CD34 can be used as important immunohistochemical markers in the diagnosis of GIST. Laparoscopic surgery compared with traditional laparotomy with trauma, postoperative recovery characteristics. GIST risk classification and tumor metastasis are closely related to patient prognosis.