Analysis Of Clinical And Pathological Characteristic Of Patients With Gastrointestinal Stromal Tumors In Qinghai Area

Objective: To investigate the clinical and pathological characteristic of patients with gastrointestinal stromal tumors in Qinghai area.Methods:Through systematical retrospective analysis of 246 cases of Qinghai area from 2009/1/1 to 2019/12/31,which diagnosed by gastroscopy,colonoscopy,puncture biopsy and postoperative pathology.The data of patients were analyzed including gender,age,tumor size,clinical manifestations,auxiliary examination,treatment methods,postoperative pathology and immunohistochemistry.Results:1.General situation:Among the 246 cases,there were 122 male patients and 124 female patients,with a male-to-female ratio of about 1:1.02.The patients ranged in age from 20 to 82 years old,with the mean age is 57.0±11.4 years old.There was no significant difference between Han,Tibetan and Hui nationality in tumor location.Gastric stromal tumors have a smaller diameter,while small intestinal stromal tumors have a larger diameter.2.Clinical manifestations:In this study,patients with abdominal discomfort accounted for 69.11%,with upper gastrointestinal bleeding accounted for 12.19%,with nausea or vomitin accounted for 2.44%,with other symptoms accounted for 6.10%,and patients with physical findings accounted for 10.16%.3.Auxiliary examination:The detection rate of abdominal CT was 91.57%,that of ordinary endoscopy was 91.13%,and ultrasound endoscopy was 100%.But there was no difference in the detection rates of the three auxiliary examinations.4.Pathology and immunohistochemistry:In this study,according to the NIH risk assessment stratify,246 patients were classified as extremely low risk(53,26.24%),low risk(42,20.79%),intermediate risk(42,20.79%)and high risk(65,32.18%).There was no significant difference in the risk of Han,Tibetan and Hui nationalities.The risk of small intestinal stromal tumor was higher than that of gastric stromal tumor in Qinghai area.Immunohistochemistry results:There were 225 patients tested for CD117 and the positive rate was 93.33%;222 patients tested for CD34 and the positive rate was 91.89%;194 patients tested for DOG-1 and the positive rate was 93.81%.Conclusions:1.There was no significant difference in the incidence of gastrointestinal stromal tumor between male and female in Qinghai area.It can occur at any age,and were most common in the elderly over 40 years of age.Gastrointestinal stromal tumors were most common in the stomach,followed by the small intestine.There was no significant difference among Han,Tibetan and Hui nationality in the composition of the disease site.2.The clinical manifestations of gastrointestinal stromal tumor in Qinghai area have no obvious specificity.Patients often come to the hospital with the main complaints of abdominal discomfort and upper gastrointestinal bleeding symptoms.They can also be asymptomatic,only detected by physical examination.3.The feasible auxiliary examinations before the operation of gastrointestinal stromal tumor include abdominal CT,endoscopy and endoscopic ultrasonography in Qinghai area.But there was no difference in the detection rates of the three auxiliary examinations.4.The main treatment methods of gastrointestinal stromal tumor in Qinghai area was surgery,and the surgical rate was 89.02%.The surgical method should be decided according to the location and size of tumor growth.5.The diagnosis of gastrointestinal stromal tumor was mainly based on histopathological examination in Qinghai area.There was no significant difference in NIH risk assessment stratify among Han,Tibetan and Hui nationalities.The rate of taking Imatinib after surgery was 37.68% in patients with medium and high risk gastrointestinal stromal tumors.6.The tumor diameter of small intestinal stromal tumor was larger than that of gastric stromal tumor in Qinghai area,and the NIH risk assessment stratify was also higher than gastric stromal tumor.