目的 探讨胃肠道间质瘤（GIST）的临床表现及诊治方法。方法 回顾性分析2003～2008年期间我院收治的35例GIST患者的临床表现和随访资料。结果 GIST发生部位：胃22例（62.8%），小肠8例（22.9%），结直肠2例（5.7%），腹膜后或肠系膜3例（8.6%）。免疫组织化学检测显示，CD117 （＋） 32例（91.4%），CD34 （＋） 18例（51.4%），SMA （＋） 4例（11.4%），S100 （＋） 2例（5.7%）。35例患者均接受了手术治疗，其中根治性手术30例，非根治性手术5例，联合脏器切除10例。随访中位时间34个月，随访率为100%（35/35）。全组患者1、3、5年累积生存率分别为95.4%、87.2%和77.9%。本组患者中有3例术后复发转移患者服用甲磺酸伊马替尼的患者至今仍带瘤生存。患者的5年累积生存率与肿瘤大小、有无肿瘤坏死、核分裂数、肿瘤细胞核异型性、肿瘤部位及手术方式有关（P＜0.05 ）。结论 GIST主要通过术后病理和免疫组织化学检测明确诊断，完整的局部手术切除是最有效的治疗手段，复发转移病例需要手术与药物治疗的结合。
【Abstract】ObjectiveTo study the influence of clinicopathologic characteristics and surgical treatment of gastric cancer on patients’ survival rate.MethodsFrom Apr.1994 to Aug.2005, the data of 759 gastric cancer patients concerning surgical treatment, pathological diagnosis and outcome were collected. Retrospective analysis of the results was made, 3-year and 5-year survival rates were calculated by Kaplan-Meier curve method, univariate analysis was done through Logrank and multiple factors comparison through Cox regression analysis, and follow-up duration was 4－131 months.ResultsSingle factor analysis indicated that age,tumor location,diameter of tumor, Borrmann type, type of histology, TNM stage, depth of infiltration, lymph node metastasis, liver metastasis, peritoneal dissemination, blood of transfusion during operation, extent of the radical cure of the tumor and excision techniques were significantly influential factors for the prognosis of patients. Cox regression analysis showed that tumor location, diameter of tumor,depth of infiltration, lymph node metastasis,liver metastasis, TNM stage, peritoneal dissemination, blood transfusion during operation, extend of the radical cure of the tumor and excision techniques were independent factors influencing the postoperative survival rate.ConclusionIndependent factors influencing the postoperative survival rate include tumor location, diameter of tumor, lymph node metastasis, infiltration depth of the tumor, pathological classification, liver metastasis, peritoneal dissemination, and TNM stage, extent of the radical cure of the tumor, lymphanodectomy techniques and blood transfusion during operation are also important factors.