| Objective:This study retrospectively analyzed the clinical data,risk classification,diagnosis and treatment process and prognosis of patients with Gastric stromal tumor(GST),and discussed the influencing factors of risk classification of Gastric stromal tumor,and the safety and effectiveness of endoscopic treatment of Gastric stromal tumor,so as to provide references for the diagnosis and treatment of GST.Methods:This study collected 69 patients diagnosed with gastric stromal tumor admitted to the second hospital of jilin university from January 2014 to November 2019,and summarized and analyzed their clinical data,treatment plan and prognosis.According to the National institutes of health(NIH)2008 interstitial tumor risk classification standard,the interstitial tumor risk group was divided into the very low risk group,the low risk group,the medium risk group and the high risk group.The 69 patients were divided into the endoscopic treatment group(23 cases),the laparoscopic treatment group(29 cases),and the open surgery treatment group(17 cases)according to different treatment methods.The characteristics of each treatment plan and the advantages of endoscopic treatment of gastric small stromal tumor(diameter ?2cm)were analyzed.SPSS 25.0 statistical software was used for all data analysis,and P <0.05 was considered statistically significant.Results:1.A total of 69 patients with gastric stromal tumor were included in this study,including 28 males and 41 females,with a male-to-female ratio of 1:1.46.The age of onset ranged from 27 to 92 years,with an average age of(59.06±12.72)years and a median age of 60 years.2.Abdominal pain was the most common clinical manifestation(31 cases,44.93%),followed by patients without any clinical symptoms(18 cases,26.09%).3.The incidence sites were gastric body(35 cases,50.72%),gastric fundus(30 cases,43.48%)and gastric antrum(4 cases,5.80%).4.The positive expression rates of CD117(92.75%),CD34(94.20%)and DOG-1(97.10%)in gastric stromal tumor were high,and the sensitivity of SMA,Desmin,S-100 and NES in gastric stromal tumor was low(the positive expression rates were all < 10%).The combined detection of multiple immunohistochemical indicators was helpful for the diagnosis of gastric stromal tumor.5.The risk classification of the 69 cases was 33 cases in the very low risk group,19 cases in the low risk group,10 cases in the medium risk group and 7 cases in the high risk group.Men had a higher risk than women(P < 0.05).Under endoscopy,the risk of irregular lesion surface was higher than that of smooth lesion surface(P < 0.05),and the risk of non-uniform echo in ultrasound was higher than that of uniform echo(P < 0.05).Ki-67 > 5% had a higher risk than Ki-67 ?5%(P < 0.05).There was no correlation between the expression of CD117,CD34,DOG-1,SMA,S-100,Desmin and NES and the risk classification(all P values were > 0.05).6.For patients with gastric mesenchymal tumor treated by laparoscopy and endoscopy,endoscopic treatment has shorter operation time,less intraoperative bleeding,fewer days in hospital and less total hospital expenses than laparoscopic treatment(P < 0.05).7.Endoscopic treatment of gastric stromal tumor with diameter ?2cm has no obvious intraoperative or postoperative complications.It is safe and effective,but it is more suitable for laparoscopic or open surgery for lesions with diameter of > 2cm.Conclusion:1.Gastric stromal tumor can occur at any age,most of which are in the elderly.There is no significant difference in the incidence rate between different genders and no specificity in clinical manifestations.2.CD117,CD34 and DOG-1 are highly sensitive in gastric stromal tumors,and the combined detection of multiple immunohistochemical indicators is helpful for the diagnosis of gastric stromal tumors.3.The risk grade of gastric stromal tumor was correlated with gender,Ki-67value-added index,the uniformity of the internal echo of the lesion and the morphology of the tumor.4.Compared with laparoscopic treatment,endoscopic treatment of gastric mesenchymal tumor has less trauma,shorter operation and hospitalization time,and lower cost.5.Endoscopic treatment of gastric stromal tumor with diameter ?2cm is feasible,but for lesions with larger diameter,laparoscopic or open surgery is more suitable. |
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