| Background:Gastrointestinal stromal tumors (Gastrointestinal Stromal Tumor GISTs) are the most common gastrointestinal tumors of mesenchymal tissue, gastrointestinal tumors not only account for about 1-2% of gastrointestinal tumors, but also 3% of the malignant tumors. A large number of studies have shown that GISTs originate from Cajal gastrointestinal stromal cells (interstitial cell of Cajal, ICC) or more na?ve cells that the ICC differentiated to. Acquired mutation occurred in Proto-oncogene receptor tyrosine kinase (cKit) or platelet-derived growth factor receptor alpha (PDGFRA), the abnormal proliferation of ICC was induced. Generally agreed that the current study, GISTs is a tumor of uncertain malignant potential, the differences between attack risk and the possibility of recurrence and metastasis exist. In 2001, according to the two indicators which were the size of the tumor diameter and the number of the number of mitotic, GISTs was divided into four groups that were very low risk, low-risk, medium risk and high-risk GISTs by NIH, This is the world's most widely used clinical outcome assessment criteria. A variety of clinical prognostic factors including race, age, sex, tumor location, cell shape, atypical, necrosis, invasion near the organ, and so on immunohistochemistry were assessed by another body of literature, These prognostic factors have different sample size in different populations, there are some differences.At present, people have already undertaken a number of GISTs clinical and basic researches. In Beijing,the topic group of Professor Wu Bingquan was one of the largest sample size research centers that was one of the earliest established.GISTs research is currently focused on the north, central and southern China. In the Northeast, fewer people carry out large-scale research. The characteristics of the Northeast are many Korean-Chinese and Manchu in the crowd, cold geographic environment and ethnic minorities. Region and the nation have had a great impact on GISTs. In 2005 the largest epidemiological investigation in the world about GIST was carried out by the United States. The results showed that, the race of GISTs was a significant difference in prevalence rate. The highest prevalence rate of African-American was 1.16/100000, followed by Asian and the Pacific islands of local residents whose prevalence rate was 1.03/100000; the lowest prevalence rate of whites was 0.6/100000. Geographical differences in the incidence of GISTs are also apparent, the area with the highest prevalence rate is Hawaii, for 1.06/100000; lowest for Alaska, to 0 cases during the study period. The different race affects the prognosis of GISTs. The highest 5-year survival rate of Asians and other ethnic groups can reach 40-60%, followed by whites, blacks who have the lowest survival rate.GISTs of some areas of our province were retrospectively analyzed. The purpose of this project is to explore the clinical characteristics, diagnostic methods and Survival factors of GIST, expecting that this research may play the clinical instruction role.Objective: To study the clinical character, diagnosis, treatment and prognosis of gastrointestinal stromal tumors.Methods: All cases of gastrointestinal stromal tumors (GIST) in First Hospital of Jilin University who were diagnosed between 2003 and 2008 were analyzed retrospectively to evaluate their clinical findings, to analyze the clinical feature, treatment and prognosis of GIST.Results: There were totally fifty-one cases. 49.0% of them had the stromal tumors in stomach and less commonly in the small intestine 39.2%. 70% of them were symptomatic, including gastrointestinal bleeding, abdominal pain and weight loss. CD117 and CD34 positive immunohistochemical rate were 90.2%and 58.8%, CD117 and CD34 were both positive in 54.9%. In the auxiliary inspection the supersonic in mirror inspection is most important. The total resection rate was 68.6%, and palliative resection rate was 29.4%. All of the 18 lymph nodes resected from the 51 patients were free from tumor metastasis. The positive immunohistochemical rate of none of the patients in the low-risk group had recurrence or distant metastasis. The rate of recurrence and metastasis in the moderate-risk or high-risk group was 61.8% after operation. For recurrent or metastatic disease, treatment with Gleeve is better than those not received Gleeve. Primary organ of tumor, tumor size, mitotic rate, and histological type are univariate analysis.Conclusions: The clinical characteristics of GISTs are different from that of other common gastrointestinal cancers. Diagnosis is relying on pathology and immunohischemistry, and CD117 is very important. Inspections and so on supersonic in mirror, CT have the important meaning to its diagnosis. Surgical resection of the primary tumor is the standard treatment for GIST. Elimination of lymph nodes regularly isn't recommended. Primary organ of tumor, tumor size, mitotic rate, and histological type are important factors which are correlated with the prognosis and risk scores. Glivec is the most effective systemic therapy for patients with metastatic or unresectable GIST. |
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