The Correlation Between Clinicopathologic Features And Risk Classification Of Gastrointestinal Stromal Tumors

Objective:To investigate the correlation between clinicopathologic features and risk classification of gastrointestinal stromal tumor (GIST). To determine accurately the patients'diagnosis and treatment of illness and to develop programs for references.Methods:Sixty three cases with gastrointestinal stromal tumors were obtained over the recent ten years from the second affiliated hospital of Dalian Medical University. Gender, age, disease location, clinical manifestations and the related examinations, tumor properties, cell morphology, CD117, CD34,α-SMA, S-100, Ki-67 index were observed, select some indices from them to analyze their relationships with risk classification of GIST.Results:Thirty one patients were males, and 32 were females(male/ female = 1/ 1.03). The patients were aged between 15-77 years(median age 60). Thirty one cases developed as the primary tumor were located in the stomach, followed by small intestine in 18 cases (28.6%), which indicated the primary tumor most commonly occurred in the stomach. Clinical symptoms were not contributable to the diagnosis. The most common symptom were abdominal pain (31.7%), followed by gastrointestinal bleeding (28.6%), nausea and (or) vomiting (23.8%) and other symptoms,such as morbidity, abdominal discomfort and decreased food appetite. The relevant examinations, intraoperative and postoperative pathologic findings suggest that most tumors were solitary, regular shaped, and the others were seen with hemorrhage and necrosis. Surrounding tissue adhesions, mucosal invasion and distant metastasis were rarely seen. Ki-67 index of less than 5% accounted for 69.4%, 5 to 10% accounted for 13.9%,> 10% accounted for 16.7%. Tumor diameter ranged from 0.6cm to 20cm, where <5cm in 21 cases (35.0%), 5cm ~ 10cm in 24 patients (40%),> 10cm in 15 cases (25%). Mitotic rate≤5/50HPF 28, 6~10/50HPF, 3,≥10/50HPF 5. Spearman rank correlation analysis were used to analysis these indices and risk classification, the results showed that tumor number, tumor necrosis, adhesion and Ki-67 index had the close association with risk of GIST.Conclusions:CD117 is a specific marker for the diagnosis of GIST, and its high expression can be seen in the vast majority of GIST. Tumor number, tumor necrosis, adhesion and Ki-67 index had the close association with risk of GIST. These indices have predictable value in the progress of GIST.