云南省肿瘤医院胃肠道间质瘤的流行病学调查和Ki-67与胃肠道间质瘤临床病理特征及危险度分级的相关性

发布时间：2018-06-02 02:29

本文选题：胃肠道间质瘤 + 流行病学　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]分析云南省肿瘤医院2010年1月至2016年12月胃肠道间质瘤的发病情况及临床病理特征,从而了解本地区GISTs的发病情况,为胃肠道间质瘤的流行病学提供一定依据,有助于加强对胃肠道间质瘤的认识,提高诊治水平。[方法]回顾性分析云南省肿瘤医院2010年1月至2016年12月期间首次病理确诊为GISTs的250例病例的临床及病理特点,对不同年龄组、不同性别组、不同民族组、不同部位组、不同组织学类型组等进行数据分析,初步得出云南省肿瘤医院胃肠道间质瘤的发病情况及临床病理特点。[结果]云南省肿瘤医院2010年1月至2016年12月期间首次病理确诊为胃肠道间质瘤的病例有250例,患病人数总体呈增长趋势。年龄范围为26-84岁,平均年龄为55. 52岁,中位年龄为55岁,发病比例最高年龄段为50-60岁,男女患病率稍有差异,男女比约为1. 33:1,发病民族以汉族为主,少数民族患病人数为29例,其中彝族与白族患病人数最多。患者主要来源以昆明市、曲靖市为主。患病部位主要为胃和小肠。主要临床症状有:腹部肿块,腹痛,腹胀,呕吐,消化道出血,排便困难,部分无症状者通常是在行其它手术或体检时发现。统计学显示:年龄在患病部位中差异有统计学意义(P0. 05);民族在有无坏死中差异有统计学意义(P0.05);其他对比差异无统计学意义(P0.05)。[结论]GISTs是一种散发少见的肿瘤,云南省肿瘤医院6年间收治的GISTs在患病时间和地区分布上没有集中趋势,发病部位主要为胃和小肠,好发年龄段为50-60岁。发病部位与年龄相关,年龄越大越好发生于胃,年龄越小越好发于小肠。[目的]探讨Ki-67的表达及其与胃肠道间质瘤的临床病理因素和危险度分级的相关性。[方法]分析77例手术切除的原发性GISTs病例的临床病理资料,采用免疫组化SP法检测Ki-67的表达,分析其表达与GISTs的临床病理因素及危险度分级的相关性。[结果]Ki-67增殖指数在肿瘤部位、核分裂、危险度分级之间的差异有统计学意义(P0. 05),而在年龄、性别、肿瘤大小,肿瘤组织学类型、肿瘤是否囊性变、单发或多发、有无出血、有无坏死及是否合并其他肿瘤之间的差异无统计学意义(P0.05),同时,Ki-67增殖指数与肿瘤部位、核分裂、单发或多发及危险度分级具有相关性(P0. 05),其中Ki-67增殖指数与核分裂及危险度分级呈正相关。[结论]Ki-67增殖指数可以作为判断GISTs危险度分级及预后预测的重要参考指标。
[Abstract]:[objective] to analyze the incidence and clinicopathological features of gastrointestinal stromal tumors (GIST) in Yunnan Cancer Hospital from January 2010 to December 2016, so as to understand the incidence of GISTs in our region and provide a basis for the epidemiology of GIST. It is helpful to strengthen the understanding of gastrointestinal stromal tumors and improve the level of diagnosis and treatment. [methods] the clinical and pathological features of 250 patients with GISTs confirmed by pathology from January 2010 to December 2016 in Yunnan Cancer Hospital were retrospectively analyzed. The incidence and clinicopathological characteristics of gastrointestinal stromal tumors (GIST) in Yunnan Cancer Hospital were preliminarily obtained by analyzing the data of different histological types. [results] from January 2010 to December 2016, there were 250 cases of gastrointestinal stromal tumors diagnosed by pathology in Yunnan Cancer Hospital. The age range is 26-84 years, with an average age of 55. 4%. The highest incidence rate was between 50 and 60 years old. There was a slight difference between male and female prevalence rate, which was about 1. 5%. 33: 1, the Han nationality was the main disease, and the minority nationality was 29 cases, of which Yi and Bai were the most affected. The main sources of patients were Kunming and Qujing. The main sites of the disease were stomach and small intestine. The main clinical symptoms were abdominal mass, abdominal pain, abdominal distension, vomiting, gastrointestinal bleeding, difficult defecation, and some asymptomatic patients were usually found in other operations or physical examination. Statistics showed that there was significant difference in age between diseased sites (P 0. 0). The difference between the two groups was statistically significant (P0.05A), but there was no significant difference in other contrasts (P 0.05). [conclusion] GISTs is a rare sporadic tumor. The incidence of GISTs in Yunnan Oncology Hospital during the past 6 years has not been concentrated in time and region. The main site of the disease is stomach and small intestine, and the predilection age is 50-60 years old. The location of the disease is related to age, the older the stomach, the better the small intestine. [objective] to investigate the expression of Ki-67 and its correlation with clinicopathological factors and risk classification of gastrointestinal stromal tumors (GIST). [methods] the clinicopathological data of 77 patients with primary GISTs were analyzed. The expression of Ki-67 was detected by immunohistochemical SP method. The correlation between the expression of Ki-67 and the clinicopathological factors and risk grade of GISTs was analyzed. [results] the difference of Ki-67 proliferation index in tumor site, mitosis and risk grade was statistically significant (P 0. 0). And in age, sex, tumor size, tumor histological type, whether the tumor is cystic, single or multiple, bleeding or not, There was no significant difference between necrosis and other tumors, and Ki-67 proliferative index was correlated with tumor site, mitosis, single or multiple, and risk grade (P0. 0). The proliferative index of Ki-67 was positively correlated with mitosis and risk grade. [conclusion] Ki-67 proliferative index can be used as an important reference index for predicting the risk and prognosis of GISTs.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735

【参考文献】