| objective:Gastrointestinal stromal tumors(GISTs)are the most common primary mesenchymal tumors of the gastrointestinal tract.The diagnosis and treatment are becoming more standardized.However the current treatment standards for gastrointestinal stromal tumors are based on the clinical data in Europe and the United States,due to the ethnic differences,whether the gastrointestinal stromal tumor treatment perscription is appropriate to our chinese people,the current domestic large number of clinical data is still small.The aim of this study was to retrospectively analyze the patients with gastrointestinal stromal tumors in order to understand the clinicopathological features and prognosis of patients with gastrointestinal stromal tumors and to explore the related factors that affect their prognosis.Materials and Methods:The clinical and pathological data of GIST patients in the First Affiliated Hospital of Zhengzhou University from July 2011 to June 2015 were analyzed retrospectively.All the cases were examined and followed up.The prognostic factors were analyzed.Results:A total of 448 cases were collected.1.Male were 199,female were 249,with age from 15 to 95(median 59)years old.Stratified by age.<40 years old: 21 cases;40-49 years old: 94 cases;50-59 years old: 126 cases;60-69 years old: 140 cases;≥70years old: 67 cases.2.Tumor diameter.0.2-29 cm,≤ 2cm:127cases;> 2cm and ≤5cm :165 cases;>5cm and≤10cm:102 cases;>10cm: 54 cases.3.Primary tumor site:the primary tumor sites including 280 cases in stomach,101 cases in small intestine,19 cases in rectum and Colon,48 cases in extra-gastrointestinal.4.Ki-67 index.<10% :320 cases;10%-20% : 92 cases;>20%:33 cases.5.Symptoms: there are 124 cases with the nausea,vomiting,acid reflux and other abdominal discomfort,and 124 cases with the abdominal pain,and 104 cases with gastrointestinal bleeding,31 cases with abdominal mass,there are 36 cases the tumors were found when taken physical examination,16 cases were found intraoperative and the others were 12 cases.6.Recurrence risk classification: 92 cases with very low recurrence risk,127 cases with low recurrence risk,98 cases with moderate recurrence risk and 131 cases with high risk of recurrence.7.Follow-up results: Of all the 448 cases,16 patients had progress,10 of whom had died,a total of 30 cases were lost,the loss rate was 7.2%.8.Analysis of prognostic factors: Univariate analysis showed that age,tumor diameter,mitosis,recurrence risk,grade and Ki-67 index were the factors that influence the disease-free survival.Multivariate analysis showed that age which less than 59 years old and Ki-67 index were significant independent influencing factors of disease-free survival.Conclusions:1.Targeted therapy can significantly improve the disease-free survival in patients with a high risk of recurrence.Adjuvant treatment with imatinib did not show the better disease-free survival in patients with moderate risk of recurrence.2.Age less than 59 years old and Ki-67 index are independent factors affecting the disease-free survival of patients,evaluation the prognosis of GIST patients should be combined with improved NIH classification criteria and Ki-67 index.3.Gastrointestinal stromal tumors often occur in the elderly,less than 59 years old patients have the better prognosis.GIST occurred in the stomach and small intestine more often,followed by colorectal.The main clinical symptoms are nausea,vomiting and other abdominal discomfort,abdominal pain and gastrointestinal bleeding. |
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