Clinical Characteristics And Risk Factors For Metastasis Analysis Of Patients With Gastrointestinal Stromal Tumors In The Western Guangxi Region

Objective: To collect and comprehensively analyze the clinical data of patients diagnosed with gastrointestinal stromal tumors(GIST)who received inpatient treatment at our hospital,to analyze the clinical characteristics of GIST patients in the western Guangxi region,and to analyze the relevant risk factors affecting the metastasis of GIST patients.The aim is to provide a reference basis for the diagnosis and treatment of GIST in the local area.Methods: A retrospective study was conducted on 204 patients diagnosed with gastrointestinal stromal tumors in the western Guangxi region who received surgical treatment and pathological diagnosis between January 1,2016 and June 30,2021 at the Affiliated Hospital of Youjiang Medical University for Nationalities.General information(age,gender,ethnicity,BMI),clinical manifestations,auxiliary examination data,pathological characteristics(tumor primary site,tumor diameter,mitotic count,histological type,surgical treatment method,immunohistochemistry,NIH risk classification,Ki67 index)were collected.SPSS 26.0 software was used to perform comparative analysis of various clinical parameters,and single-factor and multi-factor analyses were used to identify risk factors for the metastasis of gastrointestinal stromal tumors.Results:(1)General information: A total of 204 cases with complete data were included for retrospective analysis,including 101 male patients(49.5%)and 103 female patients(50.5%).The age of onset ranged from 5 to 79 years old,with a mean age of(52.94±11.922).There were 20 patients(9.8%)under 40 years old,53 patients(26.0%)between 40-49 years old,64 patients(31.4%)between 50-59 years old,59 patients(28.9%)between 60-69 years old,and 8 patients(3.9%)over 70 years old.Among them,149 patients(73.0%)were of Zhuang ethnicity and 55 patients(27.0%)were of non-Zhuang ethnicity.According to BMI grouping,there were 18 patients(8.9%)in the underweight group,128 patients(62.7%)in the normal weight range group,51 patients(25.0%)in the overweight group,and 7 patients(3.4%)in the obese group.(2)Clinical manifestations: Of the 204 patients,152 patients(74.5%)presented with abdominal pain or distension,27 patients(13.2%)presented with gastrointestinal bleeding symptoms,26 patients(12.7%)presented with fatigue symptoms,and 4 patients(4%)presented with constipation.Some patients(23 cases,11.2%)had no obvious clinical symptoms but were found through relevant health examinations.(3)Auxiliary examination: Laboratory tests showed anemia in 68 cases and elevated tumor markers in 26 cases.(4)Surgical methods: Among the 204 patients,97(47.5%)underwent traditional open surgery,65(31.9%)underwent laparoscopic surgery,and 42(20.6%)underwent endoscopic surgery to remove the lesion.(5)Pathological characteristics: The tumor originated from the stomach in the majority of cases(59.3%).The tumor diameter ranged from 0.2cm to 23 cm,with a median of 5.8cm.Among them,spindle cells were the main type in 164 cases(80.4%),epithelial-like cells were the main type in 32 cases(15.7%),and mixed type cells were the main type in 8 cases(3.9%).There were 31 cases(15.2%)of tumor metastasis.The positive expression rates of CD117,CD34,and DOG-1 by immunohistochemistry were 93.6%,89.2%,and 96.1%,respectively.(6)Univariate analysis showed that BMI,primary site of the tumor,tumor diameter,mitotic count,histological type,presence of tumor rupture and necrosis,NIH risk stratification,and Ki67 index were all factors that had an impact on the metastasis of gastrointestinal stromal tumors(GIST).Multivariate analysis results indicated that tumor size,mitotic index,tumor rupture or necrosis,and Ki67 index were independent risk factors for metastasis in GIST.Conclusion:(1)Gastrointestinal stromal tumors(GIST)have a wide range of age of onset,with a median age of 53 years and no significant gender difference in incidence.Clinical symptoms of GIST are atypical,commonly presenting as abdominal distension,discomfort,gastrointestinal bleeding,and other discomforts.The most common site of occurrence is the stomach,followed by the small intestine and then the rectum.There are no specific laboratory changes in this disease;(2)BMI,primary tumor site,tumor diameter,mitotic index,histological type,tumor rupture or necrosis,NIH risk stratification,and Ki67 index are all risk factors affecting metastasis in GIST.Among them,tumor size,mitotic index,tumor rupture or necrosis,and Ki67 index are independent risk factors for metastasis in GIST.