The Clinical And Pathological Characteristics Of Gastrointestinal Stromal Tumors Within Diameter No More Than 2cm

Background:Gastrointestinal stromal tumors(GISTs)are the most common ones among the digestive tract tumors originating from non-epithelial tissue.Most of their patients are older than 50 years when their occurrence are similar between men and women,mainly in the stomach,with histopathological observation and the immunohistochemical staining of CD117,CD34 and DOG-1 helping diagnosis.The primary treatment is surgery and adjuvant treatment of imatinib.Up to now,endoscopic treatment is also widely used in the clinical practices.We definite the GISTs within diameter no more than 2cm as the small GISTs.For the small extra gastric GISTs,resection is the first choice under different guidances,while they show different suggestions for small GISTs in the stomach.Methods:We collected,observed and recorded the clinical and pathological information of treated and definite small GISTs from The First Affiliated Hospital,College of Medicine,Zhejiang University between January 2007 and July 2016.According to the lesion location,whether being found with the surgeries of other malignant tumors or not,gender,age and tumor size,we divided the total into different subgroups,and compare the clinical and pathological information among them.And we evaluated the prognosis with modified National Institutes of Health(NIH)classification standard and found the best point for prediction.Results:A total of 186 small GIST patients engaged in the survey with the median age of 60 years old,mean age of 59.6 years old,the sex ratio was 1.14:1.00(P=0.42),72.6%occurred in the stomach.71 patients were diagnosed during other tumor operations and they were older age and smaller GIST(P<0.01).There was also a significant difference between these two groups in the gender.The median mitosis index of all was 2/50 high power field(HPF)with no difference between genders,organs and ages.It was different among groups for different sizes(P<0.01).2.2%of them showed moderate risk of recurrence.Area under the curve(AUC)of the receiver operating characteristic curve(ROC)with tumor size was 0.76 and using 1.5cm as the critical point made the Youden index biggest(sensitivity=1,specificity =0.59).Conclusions:The clinical characteristics of small GIST patients are almost similar as the overall GIST patients.There is a tendency of more mitosis index to bigger tumors.When small GISTs are less than 1.5cm with very low risk,the advice of these patients is following up on a regular certain period but not resection.