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目的:探讨影响小肠间质瘤(gastrointestinal stromal tumor,GIST)复发的高危因素。方法:回顾性分析2004年1月至2013年12月复旦大学附属中山医院收治的67例小肠GIST复发患者的临床资料。采用Kaplan-Meier法分析不同因素对小肠GIST复发时间的影响;采用Cox多因素回归分析法分析小肠GIST复发的独立影响因素。结果:单因素分析发现:肿瘤直径>10cm、核分裂象≥30个/50HPF(高倍视野)、肿瘤破裂以及R0切除患者的中位复发时间明显缩短,差异有统计学意义(P<0.05);多因素分析发现:肿瘤破裂、手术方式是小肠GIST复发的独立影响因素(P<0.05)。结论:R0切除、术中避免肿瘤破裂可延长小肠GIST的复发时间。
Objective: To investigate the risk factors of gastrointestinal stromal tumor (GIST) recurrence. Methods: The clinical data of 67 patients with GIST recurrence of small intestine admitted to Zhongshan Hospital Affiliated to Fudan University from January 2004 to December 2013 were retrospectively analyzed. Kaplan-Meier analysis of different factors on the recurrence of intestinal GIST time; Cox regression analysis of multi-factor analysis of small intestine GIST recurrence independent factors. Results: Univariate analysis showed that the median time to tumor recurrence was significantly shorter in patients with tumor diameter> 10 cm, mitosis ≥30 / 50 HPF, tumor rupture and R0 resection, with statistical significance (P <0.05). Factor analysis found that: tumor rupture, surgical approach is independent of GIST recurrence of intestinal factors (P <0.05). Conclusion: R0 resection, intraoperative avoidance of tumor rupture can extend the recurrence of intestinal GIST.