| ObjectiveGastrointestinal stromal tumors are a class of mesenchymal-derived tumors originating from the gastrointestinal tract with a low incidence,mainly in the gastrointestinal tract.in the clinical work,we will encounter pathological findings diagnosed gist but the tumor location is located outside the gastrointestinal tract,common in the mesentery,omentum,retroperitoneal,etc.we collectively refer to these interstitial tumors originating outside the gastrointestinal tract as Extraintestinal stromal tumors.Since the incidence of egist is low and the clinic is rare,we don’t know enough about high risk EGIST,The existing articles are mostly case reports,but the tumor diameter is large,and the risk grade of EGIST in clinic is mainly high risk.Therefore,this paper mainly discusses the clinical characteristics,pathological characteristics and prognostic factors of high risk egist.;To investigate the clinical features,pathological features and prognostic factors of high risk extragastrointestinal stromal tumor.MethodsRetrospective analysis of the sex,age,imaging and pathological features of 41 cases of high risk extragastrointestinal stromal tumor patients’ group diagnosed in the First Affiliated Hospital of Zhengzhou University from December 2011 to December 2016,were compared with 121 patients with high risk gastrointestinal stromal tumor group in the same center.Discuss the prognostic factors of high risk EGIST patients.ResultsAmong 41 high risk extragastrointestinal stromal tumor patients,22 were males(53.66%),19 women(46.34%),The ratio of men to women is approximately 1.16:1;Age 22-80,The median age of 41 patients with high risk extragastrointestinal stromal tumor is 61 years;Retroperitoneal and mesenteric tumors are common in tumor location;The clinical features were abdominal pain in 12 cases(29.27%),abdominal distension in 19 cases(46.34%),abdominal mass in 8 cases(19.51%),abdominal discomfort in 10 cases(24.39%)and physical examination in 3 cases(7.32%);Tumor diameter ranges from 2～30cm;median diameter of tumor size is 10cm;48.80%of patients had≥10 cm tumor size;The operation is mainly open surgery.All 41 patients with high risk extragastrointestinal stromal tumor had complete imaging examination before operation,Among them,39(95.12%)patients underwent CT and 2(4.88%)patients underwent ultrasound before surgery,High risk extragastrointestinal stromal tumor patients had a recurrence rate of 7.30%,9.80%,23.20%in 1,3 and 5 years respectively,the site of metastasis includes 5 cases of liver(50.00%),3 cases of abdominal cavity(30.00%)and 2 cases of pelvic cavity(20.00%).The proportion of tumor diameter>10 cm in high risk extragastrointestinal stromal tumor group was higher than that of patients with high risk gastrointestinal stromal tumor group(p<0.05);The positive expression rate of CD117 in high risk extragastrointestinal stromal tumor group was lower than that of patients with high risk gastrointestinal stromal tumor group(p<0.05);The positive expression rate of CD34 in high risk extragastrointestinal stromal tumor group was lower than that of patients with high risk gastrointestinal stromal tumor group(p<0.05);The proportion of open surgery in patients with high risk extragastrointestinal stromal tumor was higher than that of patients with high risk gastrointestinal stromal tumor(p<0.05).There was no significant difference in sex,age,mitotic figure,DOG-1 expression and ki-67 index between the two groups(p>0.05).Survival analysis showed that tumor location(p<0.05)and ki-67 proliferation index(p<0.05)were risk factors for recurrence in patients with high risk extragastrointestinal stromal tumor.Tumor located in the mesentery and ki-67 index>10%had poor prognosis.,.ConclusionsPatients with high risk extragastrointestinal stromal tumors have a more malignancy potential than patients with high risk gastrointestinal stromal tumor,hence poor prognosis in high risk extragastrointestinal stroma ltumor.Tumor located in the mesentery and ki-67 index>10%had poor prognosis. |
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