Diagnosis And Treatment Of Gastrointestinal Stromal Tumors In 51 Patients

Objective: To explore the clinical characteristics of gastrointestinal stromtumors(GIST)and enhance to its diagnosis,the treatment and the progno understanding.Methods: 51 GIST patients who were surgically resected at the Second Hospital Affiliated Dalian Medical University during the period from Feb 2003 to Feb 2009 were included in this analysis. Analyzed the clinical manifestation,pathological characteristics,imageology censorship (such as CT,endoscopy and EUS) and therapy modality .To obtain the independent prognostic factor, we select multitude piece clinical and pathological characteristics indexes which maybe affected the prognosis of GIST .The survival rates were calculated by Kaplan-Meier method and the prognostic factors were analyzed by univariate log-rank analysis,and Cox proportional hazards model multivariate analysis.p<0.05 was considered statistically significant. (P<0.05)Results: All of the 51 GIST patients were given therapeutics of surgical intervention. 94.3% and 77.1% of the patiens were diagnosed with tumour with CT and Endoscopy examinations. The positive express of CD117 and CD34 is 94.1% and 41.2% respectively by immunohisto- chemistry test. Follow-up visit was given to 47 patients and the follow-up visit period is from 2-70 monthes (the meso-follow-up visit time is about 22 monthes). By the time of this analysis, 36 patients are still alive and 11 patients dead. Tumour recurrence or metastasis was found in 12 patients and 11 among these kind of patients dead. The overall 3 year survival rate of the 51 GIST patients is 67%. The express factor analysis shows that gender, tumour size, the counting of caryocinesia, risk ranking, ki-67 index, tumor cellular necrosis, the integrity of tumour rection are closely related with the prognosis. Multiple factor COX regression analysis shows that the size of tumour, the number of caryocinesia and integrity of tumour rection are independent factors for the prognosis.Conclusions:GIST paitents generally do not have specific clinical situations,so the preoperative final diagnosis is low.CT,endoscopy and EUS are the most important examinations. CT is important to judge the source,size,invasion of surrounding tissue and the metatasis, and so it is of special importance for the operation about GIST. The final diagnosis of GIST depends on pathological examination.CD117 positive express is the golden diagnosis. Tumor size,mitotic count and incisive extend of the operation to the tumor are important prognostic factors. The optimal treatment of GIST is reasonable surgery excision. Molecular targeted therapy can be applied to GIST patients operated or not.