【摘要】：目的:探索胃腸道間質(zhì)瘤(Gastrointestinal stromal tumor GIST)術(shù)后復(fù)發(fā)危險(xiǎn)因素;驗(yàn)證美國(guó)紀(jì)念斯隆凱特林中心列線(xiàn)圖的臨床實(shí)用價(jià)值;方法:收集2000年6月-2009年1月在山西省腫瘤醫(yī)院接受手術(shù)治療(R0切除)、未服用靶向藥物甲磺酸伊馬替尼輔助治療的90名胃腸道間質(zhì)瘤患者的臨床病理資料、隨訪(fǎng)資料,探索影響術(shù)后復(fù)發(fā)的危險(xiǎn)因素,卡方檢驗(yàn)進(jìn)行單因素分析,Kaplan-Meier法計(jì)算生存率,Cox比例風(fēng)險(xiǎn)回歸法進(jìn)行多因素分析,以上各個(gè)統(tǒng)計(jì)學(xué)方法均通過(guò)SPSS17.0軟件實(shí)現(xiàn)。應(yīng)用美國(guó)紀(jì)念斯隆凱特林中心列線(xiàn)圖預(yù)測(cè)每位胃腸道間質(zhì)瘤患者術(shù)后的復(fù)發(fā)概率,應(yīng)用SPSS軟件,通過(guò)Bootstrop自抽樣得到新樣本概率與患者復(fù)發(fā)的真實(shí)概率比較,計(jì)算其ROC曲線(xiàn)下面積;經(jīng)COX模型多因素分析后,應(yīng)用R軟件建立新的列線(xiàn)圖模型及校準(zhǔn)曲線(xiàn);結(jié)果:應(yīng)用單變量分析發(fā)現(xiàn)腫瘤大小、核分裂像、生長(zhǎng)部位、CD117、CD34、NIH危險(xiǎn)度分級(jí)、年齡等因素有統(tǒng)計(jì)學(xué)差異(p0.05);COX模型多變量分析篩選發(fā)現(xiàn)核分裂像、腫瘤大小是獨(dú)立因素。成功建立了列線(xiàn)圖模型,其校準(zhǔn)曲線(xiàn)顯示,此曲線(xiàn)比較接近于斜率為1的直線(xiàn),說(shuō)明列線(xiàn)圖可以預(yù)測(cè)GIST術(shù)后復(fù)發(fā)風(fēng)險(xiǎn)。結(jié)論:核分裂像、腫瘤大小是影響胃腸道間質(zhì)瘤術(shù)后復(fù)發(fā)風(fēng)險(xiǎn)的獨(dú)立因素。列線(xiàn)圖可以判定胃腸道間質(zhì)瘤患者術(shù)后的復(fù)發(fā)風(fēng)險(xiǎn)概率,指導(dǎo)醫(yī)生及患者選擇合適的輔助治療方案,提供了重要的參考依據(jù)。
[Abstract]:Objective: to explore the risk factors of postoperative recurrence of gastrointestinal stromal tumors (Gastrointestinal stromal tumor GIST), and to verify the clinical value of American Memorial Sloan Caitlin Center Line Map. Methods: from June 2000 to January 2009, the clinical and pathological data of 90 patients with gastrointestinal stromal tumors who were not treated with imatinib mesylate, who underwent surgical treatment (R0 resection) in Shanxi Cancer Hospital, were collected, and the follow-up data were followed up. To explore the risk factors of postoperative recurrence, univariate analysis was performed by chi-square test, survival rate was calculated by Kaplan-Meier method, and multi-factor analysis was carried out by Cox proportional hazard regression method. All the above statistical methods were realized by SPSS17.0 software. The recurrence probability of each patient with gastrointestinal stromal tumor was predicted by using the American Memorial Sloan Caitlin Center chart. By using SPSS software, the new sample probability was compared with the true probability of recurrence by Bootstrop self sampling. The area under the ROC curve was calculated. After multi-factor analysis of COX model, a new line diagram model and calibration curve were established by R software. Results: univariate analysis showed that there were significant differences in tumor size, mitotic image, growth site, CD117,CD34,NIH risk grade, age and other factors (p0.05). Multivariate analysis of the COX model revealed mitotic images in which tumor size was an independent factor. The calibration curve shows that the curve is close to the straight line with slope of 1, which indicates that the curve can predict the risk of recurrence after GIST. Conclusion: mitotic imaging, tumor size is an independent factor affecting the risk of postoperative recurrence of gastrointestinal stromal tumors. It can be used to determine the risk of recurrence in patients with gastrointestinal stromal tumors after operation, and to guide doctors and patients to choose the appropriate adjuvant therapy, which provides an important reference for patients with gastrointestinal stromal tumors.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R735

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相關(guān)期刊論文 前1條

1 鄒慶;官泳松;;胃腸間質(zhì)瘤研究新進(jìn)展[J];胃腸病學(xué)和肝病學(xué)雜志;2009年01期

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本文編號(hào)：2448111