Clinical Analysis Of87Patients With Gastric Stromal Tumor

Objective To investigate the clinical characteristics， diagnosis， treatment andprognosis of decision factors of gastric stromal tumor.Methods Clinical data of87patients with gastric stromal tumor from January2008to January2013were analyzed.Results The patients of Gastric stromal tumor have different clinicalmanifestations，lack of patients with typical clinical manifestations. The main clinicalmanifestation were bloody stools，abdominal pain and distension. The diagnosis beforeoperation is mainly depended on gastroscope，CT，MRI，Color Doppler Ultrasound tofind the placeholder lesions in the stomach，but only12patients(13.7％)achievedpreoperative pathological diagnosis. The patients of high-low risk， low risk，intermediate risk， and high risk was13cases（14.9%），27cases（31.1%），25cases（28.7%）， and22cases （25.3%）， respectively. There are three kinds ofpostoperative pathology types，spindle cell type (75%), epithelioid cell type (17.6%)and mixed type (7.4%). Compared the level of risk and the histological type (accordingto the χ2，χ2=0.6786, P>0.05), there was no statistically significant difference, thereis no relationship between level of risk and the histological type.immunohistochemistry: CD117positive in81patients (93.1%),73cases of CD34positive (83.9%),17case was SMA positive,11cases of S-100positive. All patientsunderwent surgical resection，65partial gastrectomy，16subtotal gastrectomy，5totalgastrectomy，1combined multiple organs resection.61patients were followed-up for8-50months（average34months）. The patients of high-low risk， low risk，intermediate risk， and high risk was7cases，12cases，21cases， and21cases，respectively. Compared the tumor diameter of survival group and death group inmedium-high risk patients（according to the t, t=5.85, P <0.05），with statisticalsignificance，the tumor diameter of death group were greater than the survival group， the greater the diameter，the worse of prognosis. Compared the mitotic figure ofsurvival group and death group in medium-high risk patients（according to the t, t=5.68,P <0.05），with statistical significance，the mitotic figure of death group were more thanthe survival group，the more mitotic figure，the worse of prognosis.61patients werefollowed-up Compared the prognosis and the level of risk（according to the χ2, χ2=75, P<0.05），with statistical significance，the higher level of risk，the worse of prognosis.twenty-one patients of high risk were investigated about the drug treatment afteroperation：15cases were treated by using imatinib （tumor progressed in3cases） and16patients were not （tumor progressed in4patients）. The rate of progression ofpatients treated by imatinib was significantly lower than another group（according to theχ2，P=0.042<0.05），imatinib can improve prognosis.Conclusions1、Gastric stormal tumor is lack of specific clinical manifestations，preoperative diagnosis rate is low. Still need to improve the technology of gastricstromal tumor，to increase diagnosis rate.2、Surgery is still the preferred alternative ofgastric stromal tumor.And need to resect the tumor completely. Medium-high riskpatients should treat with imatinib.3、For patients who with high possibilities ofpostoperative recurrence or metastasis，should be regular follow-up，especially in the2years after surgery.Even if the patients have recurrence or metastasis, re-operation isrecommended. And also need to treat with imatinibe mesylate.