A Study Of Small Intestinal Stromal Tumors:clinical Prognostic Analysis And Microvascular Density Expression

Objective: To investigate the clinical characteristics,treatment and related prognostic factors and microvascular density(MVD) expression in small intestinal stromal tumor.Methods: 1.This study retrospectively analyzed the clinical and pathological features of 71 small intestinal stromal tumor patients who were hospitalized in the Union Hospital Affiliated to Fujian Medical University during Dec 2001 to Dec 2009.Kaplan-Meier and Cox regression model were used to evaluate the prognostic factors. 2.The expression of MVD was tested in 73 small intestinal stromal tumor tissues with Envision immunohistochemical method.CD105 was made as a marker of microvessel density.With the clinicopathological features, to investigate angiogenesis in small intestinal stromal tumor.Results: 1.Immunohistochemistry staining was performed with 71 cases small intestinal stromal tumor patients:68 cases positive in CD117(95.8%),61 cases positive in CD34(85.9 %),13 cases positive in SMA(18.3%),12 cases positive in S-100(16.9%).Univariate analysis showed that the postoperative 5 years survival rate of small intestinal stromal tumors patients was associated with the pattern of resection, mitotic counts,serous membrane invasion, Imatinib Mesylate therapy and tumor size(P<0.05).Multivariate analysis showed that the postoperative survival rate of small intestinal stromal tumors patients correlated with the pattern of resection, mitotic counts,serous membrane invasion, Imatinib Mesylate therapy. They were independent risk factors.The 3 years survival rate of Imatinib Mesylate therapy of recurrence metastasis patients have lived more longer than who haven′t had.Imatinib Mesylate therapy could obviously extend the postoperative survival rate.2. The expression of MVD was significantly higher in small intestinal stromal tumors(28.00±12.29) than in the normal tissues(6.45±2.51)(P<0.05).Univariate analysis showed that the expression of MVD was associated with serous membrane invasion,central necrosis,risk classification,mitotic counts,tumor size and Imatinib Mesylate therapy(P<0.05). Multivariate analysis revealed that MVD was independent risk factor(P=0.040).The recurrence metastasis rate of small intestinal stromal tumor patients with high expression of MVD(58.06%) was significantly higher than those of the patients with low expression of the marker(16.67%),the time of medium survival was short.Conclusion: 1.Completed resecting stromal tumors and Imatinib administration after operation could decrease the relapse rate and improve the prognosis.2.CD105 may participate the angiogenesis of small intestinal stromal tumors.Our results suggest that the evaluation of CD105 may be useful marker for predicting the prognostic of small intestinal stromal tumor patients.