| Objective Through a retrospective study of the clinical features,pathological features,surgical methods and postoperative use of imatinib in patients with gastrointestinal stromal tumors in Ningxia,the current situation of diagnosis and treatment in this area was analyzed,and the predictive value of various factors on the overall survival time of prognosis was evaluated.Methods The clinical,surgical,pathological and immunohistochemical data of 484 patients with gastrointestinal stromal tumors in 17 public hospitals of Ningxia Hui Autonomous region from January 1,2013 to December 31,2019 were analyzed retrospectively.To compare the relationship between different surgical methods and tumor location,tumor size,modified NIH risk classification and the effects of different surgical methods on prognosis,and to evaluate the predictive value of various factors on the overall survival time of patients with gastrointestinal stromal tumors in this area.SPSS23.0 statistical software was used for analysis.Measurement data were expressed as mean((?))± standard deviation(s),and a t-test was used for comparison between groups.The enumeration data were represented by the number of cases and percentages,and the comparison between groups was analyzed by the chi-square test.Kaplan-Meier curve was used for survival analysis,and COX regression model was used for multivariate prognosis analysis.P value <0.05 were considered statistically significant.Results Among the 484 GIST patients enrolled in the study,the choice of traditional laparotomy and laparoscopic minimally invasive surgery was related to tumor location,tumor maximum diameter,mitosis and modified NIH risk classification.The postoperative hospital stay of patients with minimally invasive laparoscopy was significantly shorter than that of patients undergoing traditional laparotomy,and there was significant difference between the two groups(P < 0.05).The results of univariate and multivariate analysis showed that gender,ABO blood group,body mass index,symptoms of first visit,CD34,DOG-1,PDGF-α,SMA and S-100 were not correlated with the overall survival time of GIST patients.Age,preoperative NLR,preoperative PLR,tumor location,tumor maximum diameter,mitosis and CD117 were correlated with overall survival.Among them,tumor maximum diameter,preoperative NLR,mitosis,and CD117 were independent factors affecting the overall survival of patients with GIST.In the modified NIH risk classification,the overall survival time of high-risk patients was closely related to the postoperative use of imatinib(P < 0.05),while there was no correlation between the overall survival time of moderate-risk patients and postoperative use of imatinib(P > 0.05).Conclusion 1.Most of the patients with gastrointestinal stromal tumors in Ningxia were over 45 years old,and the female is slightly more than the male,and the main site of the disease is the stomach.There are many kinds of surgical treatment,but the traditional laparotomy is still the main treatment.2.In GIST with tumor diameter < 5cm,located in the greater curvature of the stomach or the anterior gastric corpus wall,laparoscopic surgery can significantly shorten the postoperative hospital stay compared with traditional open surgery.Traditional laparotomy is still recommended for tumors with large diameter and disadvantageous location.3.In patients with primary gastrointestinal stromal tumors,the maximum diameter of tumor,the ratio of neutrophils to lymphocytes before operation,mitosis and CD117 may be independent factors affecting the overall survival time of prognosis.4.For high-risk patients,active IM treatment after surgery can significantly improve the prognosis.For intermediate-risk patients,it is still recommended to give IM adjuvant treatment according to GIST diagnosis and treatment guidelines. |
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