Clinical Analysis Of Malignant Gastrointestinal Stromal Tumors

Background: gastrointestinal stromal tumor(GIST) is the most common nonepitheliogenetic tumors from gastrointestinal tract. In 1983, Mazur considered that many gastric wall tumors are not only derived from smooth muscle. Some may origined from nerve sheath perineurial or mesenchymal nerve sheath cells while some from both the smooth muscle and nerve sheath. Now the conception of the GIST is based on this. But there still have many opinions on where the origination of GIST. And also have some difficult in the diagnosis and the treatment of the GIST, especially the malignant GIST. This article studys the clinical manifestation, diagnosis, treatment and prognosis of gastrointestinal stromal tumors. Methods : Retrospectivly analysis of clinical and pathological data of 34 cases of malignant GIST from 2002 to 2004. Clinical characteristics include the sex, age chief complaint the location of the tumor, the treatment and the follow up datas. Pathological characteristics include the general characteristics , histologic characteristics and immunology characteristics. Results: Median age of patients is 51. The most common clinicalpresentations are abdominal pain (13/34) and bleeding (11/34). The most common tumor locations are small intestine (14/34) and stomach (11/34). Average diameter of the tumors is 10. 2cm, 28 cases ≥5cm (28/34) . All cases were operated, and were all malignant in pathological. Fusiform cells were found in 32 cases (32/34). Mitosis(≥2 / 10 HPF)were found in 23 cases(23/34). Immunohistochemical results: CD117: (+"+++) (34/34);CD34 (+~+++) (27/34) . 12 cases recurrenced after operation and 4 cases died. Conclusion: GIST is difficult in diagnosing preoperatively. The diameter, location, mitosis and immunohistochemical data are guides to define whether it is benign or malignant. The best way now in treatment of GIST is multiple treatment including operation.