| [Objective] To explore the clinical characteristics, the prognostic factors and treatment of gastrointestinal stromal tumors.[Methods]We collect 95 cases with gastrointestinal stromal tumor(GIST) from Jul.1999 to Jun. 2006 in the Union Hospital affiliated with Fujian Medical University, and analyze the clinical and pathological characters as well as treatment in retrospective.[Results]1.Clinical and pathological characteristics: The age of these 95 patients ranges from 26 to 83 years old, and the median age is 61 years old; the incidence between male and female is about 58 versus 37. The symptom is non-specific. Among the 95 cases, there are 54.7% located in stomach, 18.9% in intestine. All 59 cases examined by computer tomography (CT) before operation gained the positve discovery. On endoscopy, 60 cases out of 66 (90.9%) appeared as submucosal mass. Immunohistochemistry staining were performed on these cases with 89 cases (93.7%) positive in CD117 and 74 cases (77.9%) positive in CD34.2.Surgical treatment result: All the patients were treated by surgery, and 68 patients received complete surgical resection(71.6%) and 24 patients received lymph node dissection or biopsy in which we got 176 lymph nodes only with one positive(1.1%).3.Targeted therapy result: Targeted therapy (Imatinib Mesylate)is administered to 45 cases and 43 cases complete follow-up with 18 cases after complete surgical resection and 25 cases after non-complete surgical resection (including recurrence or metastasis after radical surgical excision). The time of targeted therapy ranges from 3 months to 28 months, and the median theraputic time is 11 months.4. Follow-up result and survival analysis:83 cases(87.4%) complete foliow-up,and the median follow-up time is 31 months(7-83months). 26 cases died of this disease. The progression free survival rate at 1,3, 5year is 88.8%, 55.6%, 35.9% and overall survival rate is 97.8%, 71.8%, 57.0%.Univariate analyses show that the survival rate of cases with GIST is correlated with tumor location, size, mitotic count, classification, surgical procedure, treatment with Imatinib Mesylate, and the differences were statistically significant (P<0.05). But the survival rate has nothing to do with gender, age and symptom.Stratified analyses indicate: Flechers' classification after complete surgical resection and treatment with Imatinib Mesylate is relevant to postoperational recurrence free live time.Multivariate analyses show : tumor size, mitotic count, classification, surgical procedure, treatment with Imatinib Mesylate are independent prognostic factors in patients with GIST.[Conclusions]1.There is no different in morbility of GIST between male and female. GIST can originate in any location of the alimentary tract,but mostly in stomach, and the next in intestine. And extra-gastrointestinal stromal tumors aren't rare.2.Since there are no specific symptoms in GIST, it is hard to make a final diagnosis before operation. Fortunately, computer tomography and endoscopy would conduce to diagnose GIST.3.Tumors size and mitotic count are two important prognostic factors to patients with GIST. And Flechers' classification is ratinal, scientific.4.Complete surgical resection is the best therapy for primary GIST. And complete surgical resection or not is independent prognostic factor, but we don't advocate the systematic lymph node dissection.5. Imatinib Mesylate can increases the 3-year survival rate in GIST. Adjuvant targeted therapy with Imatinib Mesylate after complete surgical resection would delay recurrence and raise relapse-free survival rate.
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