| ObjectiveTo analyze the pathological features of gastrointestinal stromal tumor patients and the relationship between the pathological features and prognosis, to provide a scientific basis for clinical diagnosis and treatment.MethodWe collected 197 cases of Shandong Provincial Hospital from June 2010 to September 2013, which were all confirmed by pathological diagnosis of gastrointestinal stromal tumor. By analyzing patients’ gender, age, tumor location, size, clinical manifestations, examination methods, treatment, postoperative pathology and postoperative situation, we analyzed the relationship between the pathological features and prognosis.Results1.In this study, We collected 197 cases of Shandong Provincial Hospital from June 2010 to September 2013, which were all confirmed by pathological diagnosis of gastrointestinal stromal tumor. Grouped by the year of diagnosis,30 cases occurred from June to December in 2010,66 cases in 2011,48 cases in 2012,53 cases from January to September in 2013. There were 116 male patients and 81 female patients. The rate of male to female was 1.43:1. Age ranged 25-82 years old. The median age is 59.2.Of all the 197 patients,116 cases occurred in the stomach, while 62 cases (31.5%) occurred in duodenum,5 (2.5%) in esophagus. The liver is the most common site of metastasis of GIST. Additionally, few GIST could occur in other tissues or organs out of the digestive tract.3.Among these 197 patients, the clinical manifestations varied greatly. Abdominal pain accounted for 23.9%(47/197), bleeding for 22.8%(45/197), found by examination for 14.7%(29/197), and mass for 14.2%(28/197). Different organs have different clinical manifestations.4. Among 197 cases of patients in this study,88.6%(31/35) patients were detected by X-ray barium meal, while 91.7%(144/157) patients were detected by CT,61.8% (55/89) patients were detected by endoscope, and 100%(17/17) patients were detected by EUS.5.172 cases got surgical treatment, including 156 cases of radical surgery,16 cases of palliative surgery.25 patients got endoscopic resection. After surgery 25 patients continued their treatment with imatinib.6.1n this study,195 cases were reported whether the tumor ruptured or not, in which tumors of 14 patients ruptured.192 cases were described in tumor size, in which the proportion of tumors grouped by the size of<2cm,2-5cm,5-10cm,> 10cm was 31.8% GIST patients had statistical differences in occurrence site, surgical approach, tumor size, rupture situation, and metastasis situation.Conclusions1.The incidence of GIST in men is slightly higher than that of women. The disease can occur among all ages, but the age group of high incidence is 40-69 years.2.In all invasion sites, GIST mostly occurs in the stomach, followed by the small intestine. The liver is the most common site of metastasis of GIST. Additionally, few GIST could occur in other tissues or organs out of the digestive tract.3.GIST lacks specific clinical manifestations, in which abdominal pain, bleeding, found by physical examination and occupying are common. Different organs have different clinical manifestations.4.The diagnosis of GIST can rely on X-ray barium meal, CT, endoscopy and biopsy diagnosis, and sometimes desirable combination of EUS is also necessary.5.The main treatment of GIST is surgery, but we have to completely remove the tumor as possible as we can, and ensure negative margins, besides we must keep the tumor not broken. If the tumor is small and the origin is shallow, we can remove it by endoscopic resection.6.Imatinib is the first-line targeted therapy for GIST which is difficult to complete the surgical resection or reappear. But it is too expensive and has unbearable drug reactions, the application is irregular.7.The prognosis of GIST patients has statistical differences in occurrence site, surgical approach, tumor size, rupture situation and metastasis situation. |
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