Clinical Analysis For Small Intestinal Stromal Tumor:Review Of74Cases

AIM:To summarize the clinical characteristics of Small intestinal stromal tumors(SIST), evaluate the diagnostic values of various imaging or endoscope examinations for SIST, analyze the correlation between pathologic features of SIST and its spiral CT imaging characteristics and discuss the treatment method.METHODS:The clinical data from74patients(2004.7-2009.6) with pathologically confirmed SIST, were retrospectively collected and further analyzed.RESULTS:Of the74cases, the SIST originated from jejunum in43cases (58.1%), duodenum in17cases (23%) and ileum in10cases (13.5%). Most of patients(70/74) had clinical signs, including gastrointestinal bleeding in46cases (67.2%), epigastic pain in23cases (31.1%). Of various imaging and endoscope examinations, CT has the highest diagnosis rate (100%) and coincidence rate of diagnosis with pathologic result (72.1%). Of the74SIST lesions,14were at very low biological risk,21at low risk,15at moderate risk and24at high risk. CT examination is helpful in risk prediction for SIST. The positive rates of CD117and CD34in SIST patients were97.7%and60.5%respectively. In all patients with SIST,72patients had surgical resections of the tumor. One patient had neoadjuvant therapy with imatinib and then resected.CONCLUSION:SIST lacks special clinical symptoms, leading to difficulty in early diagnosis. Besides characters of convenient, non-invasise and reliable, spinal CT also has important role in predicting its risk and prognosis. Therefore, it could be the first choice of examinations for SIST at present. Surgery remains the treatment of choice in resectable disease. Radical resection of the tumor is important in treatment of SIST. Molecular targeted drugs are a promising new option.