| Object:The clinical data of 237 cases of gastrointestinal stromal tumor in our hospital were analyzed retrospectively to explore the clinical characteristics of gastrointestinal stromal tumor patients and analyze the prognostic factors.Methods:The clinical data of 237 patients who were admitted to our hospital from February 2014 to February 2018 and confirmed as gastrointestinal stromal tumor by postoperative pathology were analyzed retrospectively.The methods of follow-up were telephone,in-patient review,out-patient review,auxiliary examination of gastroscope,EUS,enhanced CT,MRI,etc.the last follow-up date was February2019.SPSS 22.0 statistical software was used to analyze the data collected.For the patients' gender,age,operation mode,tumor diameter,mitotic image,NIH risk classification,postoperative recurrence,treatment after recurrence,targeted treatment or not,Ki-67 The clinical characteristics and risk factors of patients with gastrointestinal stromal tumor were analyzed by single factor and multi factor analysis.When P < 0.05,the difference was statistically significant.Results:1.General situation: from February 2014 to February 2018,237 cases of gastrointestinal stromal tumor admitted to our hospital and confirmed by postoperative pathology were analyzed.There were 121 male patients and 116 female patients.The average age of the patients was(59.26 ± 2.64)years old,102 patients were younger than 59 years old,135 patients were older than 59 years old.2.Location of onset: 160(67.51%)cases in the stomach,12(5.06%)cases in the duodenum,43(18.14%)cases in the jejunum and ileum,3(1.27%)cases in the colorectal,19(8.02%)cases outside the gastrointestinal tract.The common clinical symptoms were abdominal pain in 212(89.45%),nausea,vomiting and acid regurgitation in 197(83.12%),abdominal mass in 42(17.72%),gastrointestinal bleeding in 39(16.46%),routine physical examination in 11(4.65%)and other 16(6.75%).3.Clinical features of GIST: the diameter of tumor in the first treatment of GIST patients was ? 2cm,60(25.32%)cases,76(32.07%)cases,58(24.47%)cases,43(18.14%)cases.There were 167(70.47%)cases of mitosis ? 5 / 50 hpf,27(11.39%)cases of 6-10 / 50 hpf,43(18.14%)cases of mitosis > 10 / 50 hpf.Ki-67index: 174(73.42%)patients with < 10%;42(17.72%)patients with 10%-20%;21(8.86%)patients with > 20%.4.Histomorphology and immunohistochemistry: 41(17.30%)cases were spindle cell type,172(72.57%)cases were epithelioid cell type,24(10.13%)cases were mixed type.There were 225(94.94%)CD117 positive patients,201(84.81%)CD34 positive patients and 231(97.47%)DOG-1 positive patients in 237 gastrointestinal stromal tumors.Among them,18 patients were tested for gist gene mutation,13(72.22%)patients with c-kit gene mutation,2(9 exon mutation),5(11exon mutation),3(13 exon mutation),2(17 exon mutation),1(18 exon mutation),2(11.11%)patients with PDGFRA mutation and 3(16.67%)patients with wild type.According to NIH classification,51(21.52%)patients were at very low risk,82(34.60%)patients at low risk,40(16.88%)patients at medium risk and 64(27.00%)patients at high risk.5.48 patients(20.25%)took targeted drug treatment before operation,189patients(79.75%)did not take it.58 patients(24.47%)were treated with targeteddrugs and 179 patients(75.53%)were not treated.There were 43 patients with postoperative recurrence,including 27(62.79%)patients with simple gastric recurrence,11(25.58%)patients with simple small intestinal recurrence,5(11.63%)patients with extragastrointestinal recurrence,23(53.49%)patients with simple targeted drug treatment,8(18.60%)patients with simple surgical treatment,9(20.93%)patients with targeted drug combined with surgical treatment,and 3patients with simple surgical treatment(6.98%).6.follow upThe last follow-up date was February 2019.The survival time of the patients was up to the end of follow-up or the date of death.A total of 208 patients survived and 29 died.Conclusion:1.The age of gastrointestinal stromal tumor is wide,and there is no significant difference between men and women.2.The location of gastrointestinal stromal tumor is mostly in the stomach,next to the small intestine,and rarely in the colorectal.3.Target drug therapy,risk classification,Ki-67 index,mitosis and tumor diameter were independent risk factors for prognosis.4.The main treatment of gastrointestinal stromal tumor is surgical resection,but the tumor should be completely removed as far as possible to ensure that the tumor does not rupture,and the cutting edge is negative.If the tumor can not be completely removed,and the postoperative pathology suggests that the high-risk recurrence may or has occurred metastasis,targeted drug therapy can be given. |
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