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目的回顾性分析97例胃肠道间质瘤(GISTs)患者的临床病理特征、治疗及预后。方法收集2008年1月至2013年3月出院诊断为间质瘤的所有患者,复习病历及病理诊断,逐一记录患者临床病历资料,主要包括性别、年龄、肿瘤部位、病理诊断、免疫组化检测、治疗及预后等结果,免疫组化指标主要包括Vimtin、CD117、CD34、Desmin、SMA、DOG、S-100、Ki-67等指标,通过门诊和电话随访,随访截止日期为2013年4月31日。结果胃是最多见的GISTs原发部位(57/97,58.76%),胃底是胃内最多见的GISTs原发部位(23/57,40.35%)。原发于胃的GISTs其CD34表达的阳性率为98.15%(53/54),原发于非胃部位的GISTs CD34表达的阳性率为75.00%(27/36)(P=0.0009)。Ki-67在高危、中危、低危及极低危组患者中表达的阳性率分别为67.74%(21/31)、81.25%(13/16)、21.05%(4/19)及18.75%(3/16)(?2=22.4939,P<0.0001)。Ki-67在原发于胃的GISTs与原发于非胃的GISTs中表达的阳性率分别为39.22%(20/51)和74.19%(23/31),两组差异有统计学意义(?2=9.4580,P=0.0021)。共有7例患者死亡,7例死亡患者中6例危险度分级为高度,1例为中度。结论在本组患者中胃是GIST最多见的原发部位,胃底是胃内最多见的GISTs原发部位。原发于胃的GISTs CD34表达阳性率显著高于非胃部位的GISTs。高中危组患者中Ki-67表达的阳性率显著高于极低和低危组患者。高危组患者的生存率低于其他各组患者。
Objective To retrospectively analyze the clinicopathological features, treatment and prognosis of 97 patients with gastrointestinal stromal tumors (GISTs). Methods All the patients diagnosed as stromal tumors discharged from January 2008 to March 2013 were collected. The medical records and pathological diagnosis were reviewed. The clinical records of patients were collected, including sex, age, tumor location, pathological diagnosis, immunohistochemistry , The results of treatment and prognosis, immunohistochemistry indicators include Vimtin, CD117, CD34, Desmin, SMA, DOG, S-100, Ki-67 and other indicators through outpatient and telephone follow-up, the follow-up deadline is April 31, 2013 day. Results The stomach was the most common primary site of GISTs (57/97, 58.76%). The gastric fundus was the most common site of GISTs in the stomach (23/57, 40.35%). The positive rates of CD34 expression in GISTs of primary gastric mucosa were 98.15% (53/54) and 75.00% (27/36) in non-gastric GISTs (P = 0.0009). The positive rates of Ki-67 expression in high risk, moderate risk, low risk and very low risk group were 67.74% (21/31), 81.25% (13/16), 21.05% (4/19) and 18.75% 3/16) (? 2 = 22.4939, P <0.0001). The positive rates of Ki-67 expression in primary gastric GISTs and primary non-gastric GISTs were 39.22% (20/51) and 74.19% (23/31) respectively, with significant difference between the two groups (P < 2 = 9.4580, P = 0.0021). A total of 7 patients died, and 6 of the 7 patients who died were classified as high and 1 as moderate. Conclusion The stomach is the most common primary site of GIST in this group of patients. The gastric fundus is the most common site of GISTs in the stomach. The positive rate of CD34 expression in primary gastric GISTs was significantly higher than that in non-gastric GISTs. The positive rates of Ki-67 expression in high risk group were significantly higher than those in very low and low risk group. The survival rate of patients in high risk group was lower than that in other groups.