本文選題：胃腸道間質(zhì)瘤 + 流行病學��； 參考：《昆明醫(yī)科大學》2017年碩士論文

【摘要】：[目的]分析云南省腫瘤醫(yī)院2010年1月至2016年12月胃腸道間質(zhì)瘤的發(fā)病情況及臨床病理特征,從而了解本地區(qū)GISTs的發(fā)病情況,為胃腸道間質(zhì)瘤的流行病學提供一定依據(jù),有助于加強對胃腸道間質(zhì)瘤的認識,提高診治水平。[方法]回顧性分析云南省腫瘤醫(yī)院2010年1月至2016年12月期間首次病理確診為GISTs的250例病例的臨床及病理特點,對不同年齡組、不同性別組、不同民族組、不同部位組、不同組織學類型組等進行數(shù)據(jù)分析,初步得出云南省腫瘤醫(yī)院胃腸道間質(zhì)瘤的發(fā)病情況及臨床病理特點。[結(jié)果]云南省腫瘤醫(yī)院2010年1月至2016年12月期間首次病理確診為胃腸道間質(zhì)瘤的病例有250例,患病人數(shù)總體呈增長趨勢。年齡范圍為26-84歲,平均年齡為55. 52歲,中位年齡為55歲,發(fā)病比例最高年齡段為50-60歲,男女患病率稍有差異,男女比約為1. 33:1,發(fā)病民族以漢族為主,少數(shù)民族患病人數(shù)為29例,其中彝族與白族患病人數(shù)最多�；颊咧饕獊碓匆岳ッ魇�、曲靖市為主�；疾〔课恢饕獮槲负托∧c。主要臨床癥狀有:腹部腫塊,腹痛,腹脹,嘔吐,消化道出血,排便困難,部分無癥狀者通常是在行其它手術(shù)或體檢時發(fā)現(xiàn)。統(tǒng)計學顯示:年齡在患病部位中差異有統(tǒng)計學意義(P0. 05);民族在有無壞死中差異有統(tǒng)計學意義(P0.05);其他對比差異無統(tǒng)計學意義(P0.05)。[結(jié)論]GISTs是一種散發(fā)少見的腫瘤,云南省腫瘤醫(yī)院6年間收治的GISTs在患病時間和地區(qū)分布上沒有集中趨勢,發(fā)病部位主要為胃和小腸,好發(fā)年齡段為50-60歲。發(fā)病部位與年齡相關(guān),年齡越大越好發(fā)生于胃,年齡越小越好發(fā)于小腸。[目的]探討Ki-67的表達及其與胃腸道間質(zhì)瘤的臨床病理因素和危險度分級的相關(guān)性。[方法]分析77例手術(shù)切除的原發(fā)性GISTs病例的臨床病理資料,采用免疫組化SP法檢測Ki-67的表達,分析其表達與GISTs的臨床病理因素及危險度分級的相關(guān)性。[結(jié)果]Ki-67增殖指數(shù)在腫瘤部位、核分裂、危險度分級之間的差異有統(tǒng)計學意義(P0. 05),而在年齡、性別、腫瘤大小,腫瘤組織學類型、腫瘤是否囊性變、單發(fā)或多發(fā)、有無出血、有無壞死及是否合并其他腫瘤之間的差異無統(tǒng)計學意義(P0.05),同時,Ki-67增殖指數(shù)與腫瘤部位、核分裂、單發(fā)或多發(fā)及危險度分級具有相關(guān)性(P0. 05),其中Ki-67增殖指數(shù)與核分裂及危險度分級呈正相關(guān)。[結(jié)論]Ki-67增殖指數(shù)可以作為判斷GISTs危險度分級及預后預測的重要參考指標。
[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.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R735

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