摘要
目的探讨胃肠间质瘤(GIST)伴肝转移患者以及无肝转移高危患者的临床病理特点,为GIST肝转移诊治提供参考。方法回顾性收集118例2014—2019年间四川大学华西医院胃肠外科收治的GIST患者,其中GIST首发伴肝转移56例,无肝转移高危患者62例。对两组主要临床病理指标进行对比和预后分析。结果中位随访时间31个月(8~65个月)。与无肝转移患者相比,肝转移患者相对更年轻(P=0.01)。两组患者在性别、原发肿瘤部位、大CD_(117)、CD_(34)、DOG_(1)和Ki_(67)的表达以及基因突变上均相近。肝转移组患者肿瘤核分裂象显著高于无肝转移组患者(P=0.02)。GIST无肝转移患者无复发生存期明显更长(P=0.03),两组患者总生存期相近(P=0.83)。结论GIST伴肝转移的恶性程度可能比高危无转移GIST更高。R0切除以及术后的辅助治疗依然是伴肝转移GIST治疗的关键。对于酪氨酸激酶抑制剂治疗GIST伴肝转移的时间与方案有待进一步研究。
Objective To investigate and compare the clinicopathological features of patients with gastrointestinal stromal tumor(GIST)with liver metastasis and patients with high risk GIST without liver metastasis,and to identify references for diagnosis and treatment of GIST with liver metastasis.Methods 118 patients diagnosed with GIST at West China Hospital of Sichuan University Department of Gastrointestinal Surgery from 2014 to 2019 were retrospectively included in this study.Among them,56 patients had GIST with liver metastasis,and 62 patients had high risk GIST without liver metastasis.The major clinicopathological features of patients were collected and prognostic analysis was performed.Results The median follow-up time were 31 months(8~65 months).Compared with patients without liver metastasis,those with liver metastasis were significantly younger(P=0.01).There were no statistical differences in sex,site and size of primary tumor,expression of CD117,CD34,DOG1,Ki67 and gene mutation between the two groups.The mitotic activity of patients with liver metastasis were significantly higher than those without liver metastasis(P=0.02).Patients without liver metastasis had significantly longer recurrence-free survival(P=0.03),while the two groups had similar overall survival(P=0.83).Conclusions The malignancy of GIST with liver metastasis might be higher than GIST of high risk without metastasis.R0 resection and postoperative adjuvant therapy were crucial for the treatment of GIST with liver metastasis.The duration and protocol of tyrosine kinase inhibitor treatment for GIST with liver metastasis need further studies.
作者
赵锐
万谦益
王勇
崔亚平
伍羽韬
伍晓汀
Zhao Rui;Wan Qianyi;Wang Yong;Cui Yaping;Wu Yutao;Wu Xiaoting(Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu 610041,China;West China School of Stomatology,Sichuan University,Chengdu 610041,China)
出处
《中华转移性肿瘤杂志》
2020年第1期16-19,共4页
Chinese Journal of Metastatic Cancer
关键词
胃肠道肿瘤/外科学
肝转移
胃肠道肿瘤/靶向治疗
酪氨酸激酶抑制剂
预后
Gastrointestinal neoplasms/surgery
Liver metastasis
Gastrointestinal neoplasms/targeted therapy
Tyrosine kinase inhibitor
Prognosis
作者简介
通信作者:伍晓汀,Email:wxt1@medmail.com.cn
