C-kit And PDGFR-α Gene Mutation Features And The Influence In Prognosis Of Gist Patients

[Abstract]Objective Discuss the C-kit and PDGFR-αgene mutation features and the influence inprognosis of gastrointestinal stromal tumors (GIST). Method Collected the Clinical andpathological data ,the results of gene testing and follow-up from June 2000 to January2009 in Shanxi Tumor Hospital. Used Kaplan-Meier method calculated survival andunivariate analysis, multivariate analysis used COX regression. Results Whole group in5-year disease-free survival (DFS) was 61.5%；5-year overall survival (OS) was 67.4%.PDGFR-αexon18 mutantions in 5-year DFS and 5-year OS were 100%; C-kit exon11mutations in 5-year DFS and OS were 63.4% and 70.8%; Wild-type in 5-year DFS andOS were 50.9% and 53.2%; C-kit exon9 mutations in 5-year DFS and OS were 14.3%and 50.0%. 5-year DFS of Different factors was statistically significant(P<0.05),5-year OS of Different factors P>0.05.Different mutation types in C-kit exon11, Point mutationsin 5-year DFS and OS were 87.1% and 88.1%; duplication mutations in 5-year DFS andOS were 83.3% and 100%; deletion mutations in 5-year DFS and OS were 44.9% and59.7%; 5-year DFS and OS of Differences factors were statistically significant(P<0.05respectively).Univariate analysis:age,tumor size, site of tumor, operation range,mitoticnumber,TNM staging and gene mutation were factors of prognosis of GIST patients(P<0.05). Multivariate analysis: Tumor size, site of tumor, operation range and TNMstaging is independent risk factors of prognosis(P<0.05), gene mutations was notsignificant(P=0.492).Conclusions In GIST patients who received operations and notreceived imatinib, gene mutations in GIST prognosis is better than wild-type;In differentgene mutation type, 5-year survival rate in the order of PDGFR-αexon18, C-kit exon11,wild-type, C-kit exon9;In C-kit exon11 mutation types, duplication mutations and pointmutations have better prognosis than patients with deletion mutations. Tumor size, siteof tumor, operation range and TNM staging are independent risk factors of disease-freesurvival of GIST patients,Gene mutation is not independent prognostic factor of GISTpatients.