摘要
目的评价伊马替尼治疗中危胃间质瘤患者的临床效果及预后。方法回顾性分析华西医院2007年1月至2011年7月收治的46例病理及免疫组织化学诊断为中危胃间质瘤患者的治疗情况。对服用伊马替尼患者（n=20）及未服药患者（n=26）术后无复发生存率进行单因素及多因素分析，评估伊马替尼治疗效果。结果46例患者平均随访31（9—64）个月。20例服药患者中，1例于停药后16个月发生肝转移；26例未服药患者中，5例复发或转移。服药组与未服药组1、2及3年无复发生存例数比分别为20／20比25／26、14／14比17／20、6／7比10／14。Cox风险比例回归：危险比（HR）=0．265，95％CI：O．025～2．761，P=0．267。6例复发转移的患者中5例核分裂象〉5／50高倍镜视野（HPF）。核分裂象〉5／50HPF的中危患者服用伊马替尼能改善术后无复发生存率（HR=0．059，95％CI：O．004～0．976，P=0．048）。服用伊马替尼患者常见的不良反应有水肿、恶心、腹部不适、白细胞减少等，多数为1～2级。结论中危胃间质瘤患者术后复发转移率低，预后较好。核分裂象〉5／50HPF的中危胃间质瘤患者，术后服用1年伊马替尼能够改善预后。另外，伊马替尼相关不良反应小，安全性高。
Objective To explore the clinical efficacy and prognosis of the patients with intermediate risk gastric stromal tumor （ GST）. Methods The data of intermediate risk GST patients confirmed by pathology and immunohistochemistry at Center of Gastrointestinal Surgery, West China Hospital, Sichuan University, between January 2007 and July 2011 were collected and retrospectively analyzed. And univariate and multivariate analyses were performed to assess the efficacy of imatinib mesylate （IM） according to recurrence-free survival （RFS）. Results A total of 46 intermediate risk GST patients were enrolled with a median follow-up period of 31 （9 -64） months. Among them, 20 patients received IM treatment and 1 had hepatic metasis at 16 months after withdrawal. In contrast, 5 of 26 patients refusing IM treatment recurred or had a distant metastasis. The 1-, 2-, 3-year recurrence-free survival in IM treatment group and no IM treatment group were： 20/20 vs 25/26,14/14 vs 17/20 and 6/7 vs 10/14, respectively. Cox proportion hazards regression ： hazard ratio （HR） = 0. 265,95 % CI： 0. 025 - 2. 761, P = 0. 267. Among 6 patients with recurrence and （or） metastasis, 5 had mitotic count 〉 5/50 HPF. Cox proportion hazards regression （ HR = 0. 059,95 % CI： 0. 004 - 0. 976, P = 0. 048 ） showed that IM can improve the progression free survival of mitotic count 〉 5/50 HPF group versus mitotic count 〈 5/50 HPF. The most common IM-related side effects were edema, nausea, abdominal discomfort, leukemia, etc. Most of them were Grade 1 -2. Conclusions Intermediate risk GST has a low rate of recurrence or metastasis. And 1-year 1M treatment may improve the prognosis of the patients with mitotic counts 〉 5/50 HPF. Furthermore, IM treatment is safe in intermediate risk GST patients.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第16期1230-1233,共4页
National Medical Journal of China
基金
四川省科技支撑计划项目（2012SZ0006）
关键词
胃肠道间质肿瘤
预后
中危胃间质瘤
伊马替尼
iGastrointestinal stromal tumors
Prognosis
Intermediate risk gastric stromal tumor
