| Objective:To investigate the clinicopathological features of gastrointestinal stromal tumors(GIST)by retrospective study,analyze the more commonly used surgical treatment methods,and find relevant factors that influence the prognosis,so as to improve the diagnosis rate and treatment level of GIST.Methods:The clinicopathological data of 46 patients with gastrointestinal stromal tumors from January 2010 to June 2015 in Yuxi People’s Hospital of Yunnan Province were collected.The pathological data was incompletely read and the GIST database was established.Outpatients,telephones and follow-up letters were used to follow-up to understand postoperative recurrence,drug treatment,and survival conditions.The clinical pathological features of GIST were analyzed retrospectively,and single and multivariate analysis of the prognosis was performed.Kaplan-Meier method was used for the analysis,Log-rank test was used for single factor,and Cox regression model was used for multiple factors.P<0.05 had statistical significance.Results:1.In this study,a total of 46 cases were collected,including 31 females and 15 males.2.The age distribution was<29 years old for the age of 60,accounting for 63.0%of the total,and 17 people for the>60 years old,accounting for 37.0%of the total.3.The onset was more common in the stomach and small intestine,including 16 cases of stomach,18 cases of small intestine,3 cases of colorectal,2 cases of duodenum,and 7 cases of external gastrointestinal tract.4.The tumor diameter range is 0.5-20cm,of which<2cm 1(2%),2cm≤d<5cm 11(24%),5cm≤d<10cm 15(33%),≥10cm 19 Example(41%).5.There was no obvious specificity in the first clinical manifestation.Among them,24 cases were abdominal pain(52%),6 cases were abdominal mass(13%),6 cases(13%)were vomiting blood and black stools,8 cases were abdominal distention and hernia.(18%),other clinical manifestations in 2 cases(4%).5.NIH risk classification:extremely low risk accounted for 2 cases(4%),low risk 12 cases(26%),moderate risk accounted for 14 cases(30%),high risk accounted for 18 cases(40%).6.Immunohistochemistry results:43 cases(93.4%)were positive for CD117,and 41 cases(89.1%)were positive for CD34.7.Of the 46 patients in the entire group,35 received surgery and 9 received imatinib mesylate.8.Follow-up results:Forty-six patients with GIST were successfully followed up in 41 cases,and 5 cases were lost to follow-up.The follow-up rate was 89%.9.Prognosis analysis:A total of 12 patients in the whole group died.The one-year survival rate was 97.8%,and the three-year survival rate was 76.1%.The univariate showed the patient’s age,tumor diameter,tumor location,metastasis,mitotic figures,and risk classification.It is an important factor affecting the progression-free survival;multi-factors show that the mitotic figures,tumor size and location are independent factors that affect progression-free survival.Conclusions:1.The incidence of GIST is mostly middle-aged and elderly,and there is no difference in gender.The first symptoms are non-specific.Most of them are abdominal pain,bloating,melena and abdominal mass,and the early diagnosis rate is low.2.The site of the disease is more common in the stomach and small intestine,and relatively rare in other sites such as the colorectum and mesentery.3.Immunohistochemistry CD117 and CD34 are helpful for the diagnosis and differential diagnosis of GIST.4.Surgical resection can improve the survival period,R0 resection is the fundamental purpose.5.The NIH risk classification is low,the tumor diameter is small,the degree of nuclear fission is low,and the prognosis of GIST existing in the stomach is superior to other parts.6.The use of IM drug therapy can control the development of tumors and play a role in the prognosis. |
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