Study On The Diagnosis And Treatment Of Gastric Stromal Tumor And Related Gene Expression

Objectives: To study gastric stromal tumor for its general manifestations, evaluate the clinical significance of assisted examinations, explore appropriate management for it. Method: Retrospective study of clinical material and follow-up document of 42 cases of gastric stromal tumor between 1998 and 2001. Results: The average age was 57.4 (36 to 77), 32 cases were at or over 50 years of age, contributed to 76.2% of all 42 patients. 28 were male and 14 were female, the male/female ratio was 2:1. The symptoms commonly seen were abdominal pain (38.1%) and upper gastrointestinal bleeding (40.5%). Patients without specific symptom were not rare (26.2%). Most of them did not show any physical signs. Ultrasonic examination was most commonly used, but its positive rate was not high (22%). Gastroscopy, gastroscopic ultrasound and gastrointestinalgraphy were more accurate for tumor localization. CT and MRI were not often taken, but were helpful for differentiation of tumor feature, and sometimes they gave clues of metastasis. Biopsy could be taken under gastroscopy, which reach the diagnosis only for 42.9%. The accurate rate for fast frozen pathology of resected specimen was 75%. The pre-operative diagnosis of 38 cases (90.5%) was gastric tumor. Among them, only one patient was diagnosed as gastric stromal tumor (malignant). The only effective treatment for gastric stromal tumor is surgical resection. Laparoscopic resection of gastric stromal tumor is a choice for some patients with the merit of less invasive, reduced blood loss and rapid recovery, and also effective. The method to remove tumor near the gastroesophageal junction under laparoscope mandated intensive study. No recurrence was found for benign and borderline gastric stromal tumor, but the prognosis for malignant one was bad. Conclusions: Gastric stromal tumor is rare, occurs predominantly in old patient and male patient. It lack of specific clinical manifestation. Assisted examination should be chosen appropriately to increase the accuracy of diagnosis. Individualized procedure should be taken to remove the lesion. Laparoscopic resection of gastric stromal tumor is as effective as traditional open operation for indicated patient, with the advantage of less trauma, little blood loss and rapid recovery.