Study Of Clinical Features And Prognostic Factors In264Cases Of Gastrointestinal Stromal Tumors

Objective:Investigating clinicopathologic characteristics and prognostic factors of264gastrointestinal stromal tumors;summarizing the experience of targeted drug combination with surgical resection in gastrointestinal stromal tumors.Methods:Retrospectively analyzing the clinical manifestations, pathology, treatment, and follow-up results of264patients of gastrointestinal stromal tumor who were treated in Fuzhou General Hospital of Nanjing Military Region from January2001to December2013; summing up the experience of treatment of gastrointestinal stromal tumors using targeted drugs combined with surgical resection; using Log-rank test and COX proportional hazard model to analyze the prognostic factors of gastrointestinal stromal tumor.Results:(1) There were264patients in our group,of which164cases were male, and100cases femal, with an average age of56years old. In the while, the number of cases increased gradually recent years.(2) The most common clinical manifestations was abdominal pain, followed by vomiting, dark stools and abdominal mass.(3) The primary tumor sites were distributed mainly in the stomach of159cases (60.9%), small intestine of66cases (25.3%), colorectal of13cases (5.0%), outside the gastrointestinal tract of10cases (3.8%).(4) Immunohistochemistry: CD117-positive in235/240cases (97.92%), DOG-1positive in117/127cases (92.13%).(5) There were of20cases of genetic testing in patients with GIST in our group, mutations located in exon11of c-kit gene in15cases, exon9in1case, PDGFRA D842V gene in1case, wild-type in3cases.(6)255cases of patients received surgical treatment,52cases of patients receiving imatinib mesylate treatment.(8) There were34cases/194cases (17.5%) dead in our group; the five-year survival rate was17.0%, with an average survival time was88months.Conclusions:1, The epidemiological characteristic of gastrointestinal stromal tumors in our group consistent with the report.2, In addition to tumor location, size, mitotic index and tumor broken while surgery, either metastasis while first diagnosis, surgical procedures, or time of treatment with Gleevec time was also the factor affecting survival.3, male, CD34-negative, larger tumors, metastasis while first diagnosis, shorter postoperative adjuvant treatment was more likely to metastasis.4, Targeted drugs combined surgical resection may improve the prognosis of patients with recurrence or metastasis; whether radical surgical may improve the prognosis should be concluded by further prospective clinical trial.5, genetic testing was important for diagnosis and treatment of GIST.