术前D-二聚体及纤维蛋白原含量与胃肠道间质瘤患者预后的关系

发布时间：2018-02-22 03:44

  本文关键词： 胃肠道间质肿瘤 纤维蛋白原 纤维蛋白纤维蛋白原降解物 预后　出处：《中国普通外科杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的:探讨术前血浆D-二聚体(D-D)及纤维蛋白原含量(FIB)对胃肠道间质瘤(GIST)患者术后预后的预测价值。方法:收集2010年1月—2015年12月手术治疗的170例GIST患者临床病理及随访资料,分析术前D-D及FIB水平与患者预后的关系。结果:170例GIST患者中男91例,女79例;多见于50~70岁年龄段;肿瘤原发部位最常见于胃(122例,71.8%),其次为小肠(34例,20.0%)。全组术后3、5年无复发生存率(RFS)分别为85%、75%。以生存结局(出现转移或复发)为状态变量的ROC曲线显示,D-D与FIB的最佳截点值分别为1.24mg/L、3.24g/L。单因素分析显示,D-D≥1.24mg/L、FIB≥3.24g/L、NIH危险度分级中高危、肿瘤直径5cm及胃以外部位肿瘤均与GIST患者术后3、5年RFS降低有关(均P0.05);多因素分析显示,D-D(RR=0.382,95%CI=0.151~0.967,P=0.042)、FIB(RR=0.123,95%CI=0.035~0.430,P=0.001)、肿瘤NIH危险度分级(RR=0.149,95%CI=0.042~0.524,P=0.003)是影响GIST患者术后预后的独立危险因素。GIST患者NIH危险度分级与D-D、FIB之间均存在明显相关性(r=0.648、0.868,均P0.01)。结论:术前血浆D-D及FIB可作为预测GIST患者术后预后的参考指标。
[Abstract]:Objective: to evaluate the prognostic value of preoperative plasma D-D and fibrinogen levels in patients with gastrointestinal stromal tumor (GIST). Methods: the clinicopathological and follow-up data of 170 patients with GIST from January 2010 to December 2015 were collected. Results among 170 patients with GIST, 91 were male and 79 were female. The primary site of the tumor was the most common in 122 cases of gastric carcinoma (71.8%), followed by small intestine in 34 cases (20.0%). The 3- and 5-year recurrence free survival rate of the whole group was 855.The ROC curve with survival outcome (metastasis or recurrence) as the state variable showed that D-D and FIB were the best. Single factor analysis showed that D-D 鈮，

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