| Objective:By analysing the clinical data of patients with gastrointestinal stromal tumours(GISTs),to summarize the clinical features of the disease,improve the understanding and diagnosis of gastrointestinal stromal tumours(GISTs),and guide the clinical application.Method:The data of GIST patients treated in a Grade A,Tertiary hospital from January2013 to December 2017 were collected by searching the medical record retrieval system of the hospital.All cases were confirmed as GISTs with postoperative pathology.SPSS18.0 software was used for statistical analysis and the clinicopathological data of these patients were retrospectively analysed.Measurement data were expressed as mean± standard deviation.Measurement data were analysed by t-test.P<0.05 was considered statistically significant.Count data were expressed as frequency and analysed by the Chi square test.P <0.05 was considered statistically significant.Results:1.There were 94 GIST patients.Male patients accounted for 43.62% and female patients accounted for 53.38%,with a male to female ratio of 1:1.29.There were no statistically significant differences in sex among gastric GISTs,duodenal GISTs,and small intestinal GISTs(P>0.05).The age of onset was 23~85 years old,with a median age of 61.0 years and an average age of(61.04±10.31)years.The susceptible age of small intestinal GISTs was ?60 years old,and the difference was statistically significant(P<0.05).Of the 94 GIST patients,gastric GISTs accounted for 64 cases(68.09%),duodenal GISTs accounted for 8 cases(8.51%),and small intestinal GISTs accounted for 22 cases(23.40%).Of the 94 GIST patients,87(92.55%)had a single tumour,and 7(7.45%)had multiple tumours.Among the 7 cases,3 had multiple tumours in the stomach,1 in the duodenum,and 3 in the small intestine.2.The comparison on the clinical symptoms between the three of gastric,duodenal,and small intestinal GISTs: The comparison aspects include abdominal discomfort(72.73%,33.33%,66.67%),Haemorrhage of digestive tract(18.18%,66.67%,22.22%),abdominal mass(9.01%,0%,11.11%).The main clinical manifestations of gastric and small intestinal GISTs in the stomach were abdominal discomfort,and the difference was statistically significant(P<0.05).It suggested that the main clinical manifestation of gastric GISTs and small intestinal GISTs was abdominal discomfort.3.Of the 94 patients with GISTs at different sites,gastric GISTs with a diameter of ?2cm were the most common and accounted for 40.30%;gastric GISTs with a diameter of >10cm were the rarest and accounted for 4.48%.The difference was statistically significant(P<0.05).It suggested that most gastric GISTs were ?2cm in diameter and those > 10 cm in diameter were rare.4.Of the 94 patients,the surface of most GISTs was smooth under endoscopy,and gastric GISTs accounted for 76.12%.Compared with the non-smooth group,the difference was statistically significant(P<0.05),suggesting that most gastric GISTs were smooth under endoscopy.In the smooth group,the detection rates of gastric,duodenal,and small intestinal GISTs under endoscopy were no statistically significant differences(P>0.05).5.Of the 94 patients,the double positive rates of CD117 and DOG-1 of gastric,duodenal,and small intestinal GISTs were 98.51%,88.89%,and 92.00%,respectively.Compared with the single positive rate,the differences were statistically significant(P<0.05).Further statistics showed no statistical difference in the double positive rate of gastric,duodenal and small intestinal GISTs(P>0.05).6.Of the 94 patients,in the histological type,most cells of gastric,duodenal,and small intestinal GISTs were spindle cells,accounting for 97.01%,88.89%,96.00%,and the difference was statistically significant(P<0.05).It suggested that the histological type of gastric,duodenal,and small intestinal GISTs were mainly manifested as the spindle cell type.7.The invasion potential of GISTs in the 94 cases was different.The difference of risk of invasion of gastric and duodenal GISTs in extremely low risk group,low risk group,middle risk group and high risk group were no statistically significant(P>0.05).Small intestinal GISTs,however,were mainly in the high risk group(72.00%)and the difference was statistically significant(P<0.05).It suggested that small intestinal GISTs had the highest invasion potential.Further statistics on the incidence of the high risk group showed that the incidence of small intestinal GISTs was higher than that of GISTs in other parts,and the difference was statistically significant(P<0.05).It suggested that small intestinal GISTs had the high risk incidence was higher than GISTs in other parts.8.In the high risk group,the majority aged between 40 and 60(40<age<60,51.72%)and the minority aged<40(6.9%);the difference was statistically significant(P<0.05).It suggested that GIST patients with high-risk invasion potential mainly aged between 40 and 60(40<age<60).There was no significant difference in sex among the 94 cases of different invasion potential(P>0.05).9.The clinical manifestation of patients in the extremely low risk group was abdominal discomfort,accounting for 20.21%,and the difference was statistically significant(P<0.05).It suggested that abdominal discomfort was the main clinical manifestation of GIST patients with extremely low risk of invasion.10.Tumours in the extremely low risk group were mainly at a diameter between 2 and5cm(2cm<diameter?5cm,77.42%),while in the low risk group and high risk group,the diameter was mainly between 5 and 10cm(5cm<diameter?10cm),accounting for 75%and 51.72%,respectively.The difference was statistically significant(P<0.05).It suggested that tumours in the low risk and high risk groups were mainly at a diameter between 5 and 10cm(5cm<diameter?10cm).11.Of the 94 cases,tumours with a smooth surface were mainly in the extremely low risk and low risk groups,accounting for 96.00% and 77.42% respectively,and the difference was statistically significant(P<0.05).It suggested that most tumours with extremely low risk and low risk of invasion had a smooth surface.Conclusion:1.Gastric and small intestinal GISTs often occurred in patients aged ? 60.Duodenal GISTs often occurred in patients aged 40~60.There was no significant difference in incidence between men and women.2.The main clinical manifestation of gastric and small intestinal GISTs was abdominal discomfort,and duodenal GISTs were rare.3.There were high positive rates of CD117 and DOG-1,and spindle cells were the most common histological type of gastric GISTs.4.Most gastric GISTs were ? 2cm in diameter.Most small intestinal GISTs were >5cm in diameter.5.Small intestinal GISTs contributed the highest invasion risk and the highest high risk incidence among GISTs in the three organs. |
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