The Clinical Diagnosis And Treatment Of Gastrointestinal Stromal Tumers: A Report Of 57 Cases

Objective:To investigate the clinical characteristics,diagnosis, treatment and prognosis of gastrointestinal stromal tumors(GIST).Methods:57 patients with GIST treated in Shandong University Qilu hospital from May 2004 to February 2009 were collected,and their clinical characteristics,diagnosis,treatment and prognosis were retrospectively.Results:There were 25 males,32 females with age of 24-68 years and 51.3 years on average.Tumors located in stomach in 44 cases(77.2%), duodenum in 2 cases(3.5%),jejunum in 4 cases(7.0%),ileum in 5 cases (8.8%,one of them was a recurrent case.),colon in 1 cases(1.7%),rectum in 1 cases(1.7%) respectively.The commonest symptoms were abdominal pain and abdominal distention(52.6%),Melena or hematochezia(15.5%).All the patients were treated by surgical excision.Postoperative patho-analysis diagnosed as low risk in 4 cases(7.0%),intermidiate risk in 43 cases(75.4%),high risk in 10 cases(17.5%).Low risk GIST in 4 cases were followed-up visited for 22.5 months on average,none of them had local recurrence or metastasis,intermidiate risk GIST in 43 cases were followed-up visited for 18.8 months on average,3 cases relapsed and had surgical excision again,high risk GIST in 10 cases were followed-up visited for 20.2 months on average,2 cases with local recurrence were treated by surgical excision,1 case had liver and lung metastasis and 1 case deceased.2 cases in high risk GIST took chemotherapeutics and their survival period was be prolonged obviously.Conclusion:GIST lacks representative clinical manifestations,so it is formidable to make conclusive preoperative diagnosis.The application of ultrasonic endoscope and immunohistochemistry could enhance the rate of definite diagnosis.Primary tumer site,tumer size and mitotic index are the most important indices to estimate the risk of GIST. Currently surgical excision is still the fundamental therapeutics and it is should be positively to take re-operation for the recurrent or metastatic cases.Chemotherapeutics is beneficial to intermidiate and high risk cases.