摘要目的：分析不同治疗方法治疗小肠胃肠间质瘤（GIST）的疗效及其预后。方法回顾性分析2004-2013年间北京解放军总医院收治的63例小肠GIST患者的临床资料。根据是否完整切除肿瘤及术后是否服用伊马替尼进行分组，获手术R0切除的55例患者分为R0切除加服药组（13例）和R0切除未服药组（42例），肿瘤未获R0切除的8例患者分为非R0切除加服药组（7例）和非R0切除未服药组（1例），比较不同治疗方法患者的的生存情况。结果全组病例术后中位随访时间为24（3～120）月，1、3、5年总体生存率分别为97％、94％和80％。R0切除加服药组、R0切除未服药组、非R0切除加服药组患者中位疾病无进展生存期分别为24、24和23月；术后1年疾病无进展生存率（PFS）分别为100％、97％和83％，3年PFS分别为100％、45％和83％，5年PFS分别为100％、28％和42％，R0切除加服药组PFS明显高于其他治疗组（均P＜0．05）；而非R0切除亦未服药的1例患者于术后6月死亡。获R0切除的55例患者16例肿瘤复发，术后1、3、5年复发率分别为2％、43％和58％。其中局部复发8例，肝脏复发3例，广泛复发5例；分别予以单纯伊马替尼治疗、手术加伊马替尼治疗以及伊马替尼加介入治疗，中位生存时间分别为65.5月、92.5月和48月；主动放弃治疗的1例17月后死亡。结论手术完整切除肿瘤并术后服用伊马替尼可有效改善患者预后，提高无疾病进展生存率。

abstractsObjective To analyze the efficacy and prognosis of different treatments on small intestinal gastrointestinal stromal tumors (SIGIST). Methods Clinical data of 63 patients with SIGIST who were admitted to the Chinese PLA General Hospital from January 2004 to December 2013 were analyzed retrospectively. According to resection procedure and postoperative use of imatinib, patients were divided into R0 resection plus imatinib group (13 cases), R0 resection without imatinib group (42 cases), non-R0 resection plus imatinib group (7 cases), non-R0 resection without imatinib group (1 case). Survival was compared among groups. Result All the patients were followed up with a median length of 24 months(3 to 120 months), and the over survival (OS) rates at 1-year, 3-year, 5-year were 97%, 94% and 80%. In R0 resection plus imatinib group, R0 resection without imatinib group, and non-R0 resection plus imatinib group, the progression free survival (PFS) time was 24, 24 and 23 months; the 1-year PFS were 100%, 97% and 83%; the 3-year PFS were 100%, 45% and 83%; the 5-year PFS were 100%, 28% and 42%. R0 resection plus imatinib group had significantly higher PFS (all P<0.05). The case of non-R0 resection without imatinib died 6 months after operation. Among 55 patients undergoing R0 resection, recurrence was found in 16 patients, whose recurrence rates of 1-year, 3-yeart and 5-year were 2%,43% and 58%. Local recurrence was found in 8 cases, hepatic recurrence in 3 cases and widespread recurrence in 5 cases , who received simple imatinib , operation plus imatinib and imatinib intervention, with median survival time of 66.5 months, 92.5 months and 48 months respectively. One patient initiatively abandoned treatment and died 17 months later. Conclusion The total resection and postoperative imatinib administration can improve the prognosis and raise the progression free survival of patients with small intestinal stromal tumors.