Retrospectively Analyzed To126Cases Of Gastrointestinal Stromal Tumors

Objective: To investigate the correlation clinical features of gastrointestinal stromaltumor and prognostic factors.Methods: Collect and analyze the clinical and follow-up dat of the gastrointestinalstromal tumors between January2006to May2013.Results:1、Gastrointestinal stromal tumors locations:stomach:72cases,esophagus:4cases,Jejunum and ileum:24cases, duodenum:9cases, the rectum:8cases，colon:6cases, mesenteric:2cases and rectal merge small intestine:1case.2、Clinical manifestations: The most common manifestations is upper abdominal painand discomfort:47cases (37.3%), gastrointestinal hemorrhage:35patients (27.8%),abdominal mass:22cases (17.5%), intestinal obstruction:8cases (6.35%),individual patients showed acid reflux, belching, changes in bowel habits and traits,urinating difficulty etc.3、Auxiliary examination:68cases of patients undergone CT examination beforesurgery while35cases get the diagnosis of gastrointestinal stromal tumors(51.5%);16cases of patients got abdominal colorful ultrasound,all were promptedlesions while no one can get the accurate diagnosis; and10cases got uppergastrointestinal barium meal, but no one can get the diagnosis correctly when only8cases prompted lesions;61cases got gastroscopy,of which45cases of stromaltumors prompt compliance with the performance, and were recommended ultrasoundendoscopy; A total of25cases got EUS, and24patients were able to make thediagnosis of stromal tumors (96.0%).4、Because of distant metastasis and economic factors,four cases gave up surgery,anda total of122patients underwent surgery, and R0resection:105cases, R1resection:9cases, R2resection:8cases. Postoperatively all specimens were confirmed by immunohistochemistry and paralleled classification of malignant potential: a verylow degree of risk:4cases, low risk:36cases, moderate risk:13cases, high risk:69cases.5.122patients were successfully followed up,17patients recurred at last, and themedian time of recurrence is16months,21patients were dead at the end point offollowing up; Univariate log-rank analysis showed that the prognosis of patients wascorrelated with tumor size, whether R0resection, the tumor rupture, mitotic index,and malignant potential classification (P<0.01), and multivariate Cox regressionanalysis showed that: Tumor size （P：0.048，Exp（B）：2.2709，95%CI：1.007-7.288），mitotic index（P：0.034，Exp（B）：3.842，95%CI：1.107-13.333），whether R0resection (P：0.000，Exp（B）：29.269，95%CI：9.734-88.010), malignant potentialclassification (P：0.019，Exp（B）：6.451，95%CI：1.364-30.503）were independentprognostic factors.Conclusion: The clinical manifestations of gastrointestinal stromal tumors lack ofspecificity；Accurate preoperative diagnosis is difficult,and CT and EUS has a higherdiagnostic value;The accurate diagnosis mainly rely on pathology andimmunohistochemistry;surgery is the main treatment； Single factor classification andmultivariate logistic regression analysis showed that tumor size, mitotic index,whether R0resection and malignant potential classification are independentprognostic factors.