| Objective: through the general situation,clinical manifestation,the advantages and disadvantages of all kinds of auxiliary examination,pathological characteristics,diagnosis and treatment,prognosis and prognostic factors of analysis of the disease in patients with gastrointestinal stromal tumor,Provide theoretical basis for clinical treatment and prognosis prediction,and to promote clinical doctors on the progress of the disease early diagnosis and treatment level,reduce the misdiagnosis and missed diagnosis.Materials and methods: We collected 124 cases of clinical data of our hospital from junaury 2007 to august 2017,which were all confirmed pathological diagnosis of gastrointestinal stromal tumor;By retrospectively analyzed the clinical data of patients with gastrointestinal stromal tumor,imaging examination method,X-ray barium meal and endoscopy,EUS,MSCT and MRI,abdominal B ultrasound and some other examinations.According to patients’ follow-up,using the single factor analysis,We analyzed the ralationship between gender,age,tumor size,location,tumor metastasis,whether complete tumor resection,nuclear fission and whether targeted therapy after surgery between prognosis.Results: Based on the statistics of 124 cases of patients with gastrointestinal stromal tumor which were confirmed by postoperative pathological examination from junuary2007 to August 2016,of which 0-40 years old patients accounted for 6 cases,41-60 years old accounted for 52 cases of patients,aged 61-84 patients accounted for 66 years old,the youngest patient was 20 years old,the maximum age of the patients was 84 years.The onset of the median age was 63 years.There were 58 males and 66 females,with a male to female ratio of 0.88:1.Clinical manifestation: of 124 cases of patients with gastrointestinal stromal tumor,clinical manifestations are different.Which found 38 cases,accounted for 30.65% of the most common manifestations of physical examination;followed by abdominal discomfort(such as abdominal pain,abdominal distension)for 36 cases,accounting for29.03%;bleeding again for the digestive tract(such as hematemesis,melena,bloody stool)for 17 cases,accounting for 13.71%;a variety of clinical manifestations(such as abdominal pain with it blood)in 12 cases,accounting for 9.68%;nausea,vomiting and diarrhea in 8 cases,accounting for 6.45%;abdominal mass in 5 cases,accounting for4.03%;and 4 cases of bowel habits,weight loss accounted for 3.23%,other clinical manifestations such as dysphagia,intestinal obstruction,intestinal perforation is rare,a total of 4 cases,accounting for 3.23%.In this group of 124 patients,the most common site for the stomach in 91 cases(73.39%),followed by small intestine in 17 cases(13.71%),duodenum in 12 cases(9.68%),there is one case of esophagus,colon,rectum,appendix.Auxiliary examination: 124 cases of patients,85 cases were examined by CT(plain and enhanced or),abdominal mass in 78 cases were detected,the detection rate of 91.76%,58 patients underwent endoscopy(gastroscopy or colonoscopy),endoscopic see 42 lesions,the detection rate was 72.41%,12 patients underwent ultrasound examination,found the 8 lesions,the detection rate was 66.67%,EUS and MRI examination were 12 cases and 4 cases,the detection rate was 100%.Treatment: all of the 124 patients in this study after surgical treatment,the patients underwent surgical treatment for 121 cases of patients underwent radical surgery,the number of 119 cases,the number of patients who underwent palliative surgery in 2cases;endoscopic resection for 3 cases.Molecular targeted therapy with imatinib in 7patients.Pathology and immunohistochemistry: 124 cases of patients with very low risk,low risk,moderate risk and high risk were included in this study.The results showed that the number of patients with very low risk,low risk,moderate risk and high risk were 14 cases,24 cases and 26 cases.According to the tumor diameter of 2cm,2-5cm,5-10 cm,> 10 cm group,the number and proportion of cases were 25 cases(20.16%),63cases(50.81%),25 cases(20.16%),and 11 cases(8.87%).All 124 cases of postoperative pathology and immunohistochemistry were confirmed by GIST,CDll7(+)119 cases(95.97%),CD34(+)106 cases(85.80%),S-100(+)11 cases(8.87%),SMA(+)19 cases(15.32%),Desmin(+)for 9 cases(7.26%).Follow up: of the 124 patients in this study,there were 89 cases,35 cases were lost to follow-up rate of 71.11%.The shortest follow-up time was 2 months,the longest follow-up time was 108 months,the median follow-up time was 45 months.In 89 cases were followed up,there were 10 cases of postoperative death,the survival time was from 5 to 95 months,and there were male and female in 6 cases.The patients were survival analysis indicated that the prognosis of GIST and surgical options(P = 0.001),tumor size difference(P = 0.026),preoperative tumor metastasis(P < 0.001)difference was statistically significant.Conclusion:(1)GIST can occur at any age,the median age of onset is 63 years old,Few onset before the age of 40,the incidence of male and female is not obvious difference.(2)The clinical manifestations of GIST are numerous and varied,and the auxiliary examination is lack of specificity.The diagnosis depends on pathology and immunohistochemistry.(3)Surgery is the preferred treatment for patients with primary and metastatic GIST,the principle of operation is to completely remove the lesion,to ensure that the margin is negative,and to avoid tumor rupture.(4)The prognosis of GIST was significantly different from that of surgical method,tumor size and tumor metastasis before operation. |
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