ETV1 Expression And Clinical Pathological Characteristics And Prognosis Of Gastrointestinal Stromal Tumor

Objective:1. To investigate the Clinical features in the different type of gastrointestinal stromal tumor and clinical characteristics of diagnosis and treatment in recent years;2. To discuss the expression of ETV1 protein under different clinical pathologic factors, and expression difference and correlation with CD117, DOG-1, CD34 protein;3. Discuss histopathologic characteristics and analyze the prognosis of GIST patients and possible factors that influence the prognosis for index to evaluate prognosis of GIST of molecular pathology.Method : 1. By collecting case files and follow-up to 115 cases of GISTpatients who were treated with surgically resected between January 2005 and December 2005 in the People’s Hospital of Guangxi Zhuang Autonomous Region, retrospectively analyze the the clinical, pathological and survival data.2. Using immunohistochemistry(IHC) method combined Gene sequencing method to detect this group of specimens of 115 cases of GIST of ETV1, CD117, DOG-1, CD34 protein expression.3. Survival analys is: Using SPSS 19. 0 for statistical processing, survival curve plotting by the Kaplan- Meier method, s univariate survival analys is usd the Log- rank test, multivariate survival analysis use Cox regression. P < 0.05 for significant differences.Result:1. 115 cases of GIST cases, ages 24 to 83, the median age of 57, male 49 cases(42.6%), female, 66 cases(57.4%). GIST tumor primary site distribution is as follows: primary gastric 57 cases(52.1%), 30 cases of primary small intestine(26.1%), primary colorectal 7 cases(6.1%), primary in 3 cases(2.6%) of the esophagus, 15 cases(13.0%) primary in other parts of the(peritoneal, mesentery etc.). 20 cases(17.4%) patients metastasis, and 8 cases(7.0%) confirmed with the metastases. According to parts: 8 cases of pure liver metastasis, 2 cases of pure spleen metastasis, 1 case of simple metastasis of prostate, 9 cases of abdominal widespread metastases. 2. This group of 115 cases of GIST patients, 6 cases withdraw p(5.2%), 5-108 months of follow-up, the median follow-up time was 31 months. 25 cases, total tumor related deaths occur recurrence 18 cases(14 cases) death. All GIST patients 1-year, 3-years, 5-years overall survival rate of 95%, 76%, 58%, for patients with radical resection rates, 3-years overall survival rate was 84% and 5-years overall survival rate was 70%, the 3-years disease-free survival rates were 77%. Tumor size, NIH risk grade, operation method, metastasis situation is the effect of prognosis of Gl ST transfer situation. metastasis situation is the independent prognostic factor. 3. ETV1, CD117, CD34 and DOG-1 protein positive rate were 92.2%, 89.6%, 92.2%, 84.2%, ETV1, CD117, DOG-1, CD34 protein, there was no significant difference between the expression percentage of statistical, and they have no correlation of expression. ETV1 protein in CD117 negative GIST and Wild-type GIST have higher expression percentage, positive rate are 83.3% and 81.8% respectively,and higher than the DOG-1 and CD34 protein, but have of no statistical difference with the DOG-1 and CD34 protein expression. ETV1 can improve GIST diagnostic rate of non- sequencing. 4.T he expression of ETV1 have statistically significant in different nuclear fission and NIH risk grade. 5. For patients with radical resection, the 3-years disease-free survival rates have statistical difference in different expression of ETV1 and NIH risk grade, patients of ETV1 positive expression comparison with patients of ETV1 negative expression, recurrence rates is declined and 3 year disease-free survival rate is higher.Conclusion:1. ETV1 protein have high expression percentage in various GIST, has the high sensitivity, have a good supplement diagnosis function in CD117 negative GIST and wild type GIST, can improve the GIST diagnostic rate of non- sequencing, reduce missed diagnosis. Use ETV1 protein as treatment targets need to be further exploration and research. 2. for patients with radical resection, the 3-years disease-free survival rate have statistical difference in different expression of ETV1 and NIH risk grade, but they still can not to be used as independent prognostic factor of GIST, the concrete mechanism still needs further research. 3. The factors affecting the overall prognosis of GIST are: tumor size, NIH risk grade, operation method, the transfer situation, whether the shift is independent prognostic factor.