| ObjectiveThrough analyzing the clinical data of gastrointestinal stromal tumor,the clinical manifestations,strategies of the diagnosis and related factors affecting the prognosis of gastrointestinal stromal tumor were also discussed to provide the theoretical basis for the clinical diagnosis and prognosis evaluation of gastrointestinal stromal tumor.MethodsWe collected 130 cases of Clinical data of our hospital from April2010 to March 2013,which were all confirmed pathological diagnosis of gastrointestinal stromal tumor.The clinical data of the patients were retrospectively analyzed,including the gender,age,clinical manifestation,relevant auxiliary examinations,tumor site,tumor size,treatment method,postoperative pathology,targeted therapy and postoperative follow-up results,and analysis of these indicators and prognosis relationship.Results1.Among 130 patients with gastrointestinal stromal tumor,the 61 patients were male and the others were female.The age of onset ranged from 27 to 81,and the median age of onset was 58.There were significant differences in clinical manifestations: 32 cases had abdominal pain,24 cases had gastrointestinal bleeding,35 cases were found after physical examination,7 cases had intestinal obstruction,5 cases had abdominal mass,and other 27 cases.Tumor site: 104 cases in the stomach,20 cases in the small intestine,4 cases in the rectum,1 case in the duodenum and 1case in colon.Auxiliary examination methods: 98 cases were examined by CT,60 cases by digestive endoscopy,18 cases by gastrointestinal radiography,23 cases by EUS and 2 cases by MRI.2.All the 130 patients received surgical treatment,including 72 patients underwent laparotomy,30 underwent laparoscopic surgery and 28 underwent endoscopic resection.40 cases with tumor diameter <2.0 cm,41 cases with 2.0-5.0 cm,34 cases with 5.0-10.0 cm and 15 cases were ?10.0cm.According the modified NIH risk classification,39 cases were in very low risk,34 cases in low risk,17 cases in middle risk,40 cases in high risk.The results of immunohistochemistry showed that 123 cases were CD117 positive,113 cases were dog-1 positive,120 cases were CD34 positive,91 cases were ki-67 positive,and 16 cases were s-100 positive.The mitotic count(/50HPF)of 78 cases were ?5,17 cases were between6-10,10 cases were >10.23 patients received oral imatinib mesylate as adjuvant therapy after surgery.3.The follow-up time of 130 patients was 60 months:24 patients were lost,13 patients had recurrence,and 12 patients died.Survival analysis showed that the prognosis of GIST was related to the tumor size,mitotic count and risk grade.The difference was statistically significant(p<0.05).Conclusion:1.Gastrointestinal stromal tumors have no significant difference in the incidence rate of males and females,which can occur in any ages.The high-incidence age range is 40-70 years old.2.Gastrointestinal stromal tumors mainly occur in the stomach,followed by the small intestine,colorectum and duodenum.Surgical resection of the tumor is the most important and effective method for the gastrointestinal stromal tumor.The smaller gastric stromal tumor originated from the muscularis propria can be resected under endoscopy.3.Gastrointestinal stromal tumors lack specific clinical manifestations,mainly manifested as abdominal pain,gastrointestinal bleeding,intestinal obstruction,abdominal mass and so on.Related auxiliary examinations can rely on CT,endoscopy,gastrointestinal radiography,EUS,etc.CT is the most widely used and EUS has the highest detection rate,which can be combined to improve the diagnostic rate.Preoperative diagnosis of gastrointestinal stromal tumor is difficult,and the diagnosis mainly depends on postoperative histopathology,immunohistochemistry and genetic testing.4.The prognosis of gastrointestinal stromal tumor was related to tumor size,mitotic count and risk grade,and the difference was statistically significant. |
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