The Multivariate Analysis For The Prognosis Of Gastrointestinal Stromal Tumor

ObjectiveTo investigate the influence of various clinical factors on the prognosisof patients with gastrointestinal stromal tumor (GIST).MethodsBetween December2005and December2010，38cases of GISTpatients were underwent operation and diagnosis by pathologicalobservation in the first affiliated hospital of Chongqing medical university.The demographic characteristics, clinical manifestation, radiologicalfeatures, operation approach and pathological variables wereretrospectively analyzed and correlated to the survival of them.ResultsThere were20males and18females in38GIST patients with medianage61(17～79years old). Non specific clinical manifestation was foundamong the GIST patients. Referring to the location of the primary tumor, 22cases occurred in stomach (57.9%),11in intestines (29.0%),2in pelviccavity and colon respectively (5.2%) and1in retroperitoneum (2.6%).All of the38patients underwent surgery. Based on the pathologicalexamination and immunohistochemical evaluation, the tumors wereclassified to low risk in11cases (28.9%), moderate risk in9cases (23.7%)and high risk of GIST in18cases (47.4%). CD117(+～+++) was positivestained in34(89.5%) samples in the immunohistochmestry evaluation, andCD34was expressed in32(82.4%) tumors.Tumor size and the loss of CD117were associate with patients’ death.The risk of death was14.787times higher in the patients with tumor≥10cmin the greatest dimension than the others, the death risk of patients withCD117-positive tumors was0.052times as the ones with CD117-negativetumors.ConclusionGIST is more common in elderly patients. Gender difference wasabsent in the the patients with GIST. It can be observed in various parts ofthe digestive tract, as well as pelvic cavity and retroperitonium. While,most of the GIST occurs in the stomach followed with small intestine and itis rare in colon, esophagi, mesengial, pelvic and peritoneal cavity. Theclinical symptoms of GIST was non specific. While, the tumors always waspositive in CT scan and endoscopic examination is helpful in the diagnosis of primary gastrointestinal GIST. The definite diagnosis of GIST requiresnot only routinely pathological observation but also theimmunohistochemical evaluation of the markers as CD117and CD34.GIST is insensitive to ether radiotherapy nor chemotherapy, removalexcision is the first choice for GIST. However, radical resection could notprovide further benefit for the patients survival compared to local excision.Tumor size is an important prognosis predictor for GIST patients. Andthe expression of CD117is also a helpful predictor. Both of them wereassociated with the death of patients with GIST significantly.