Clinical Features And Prognostic Factors In170Cases Of Gastrointestinal Stromal Tumors

Objective: To analyze clinical features and prognostic factors of GISTs，in order toimprove the diagnosis and treatment，provide a reference for prognostic evaluation.Methods:170GISTs in the Fujian Provincial Hospital from January2002toDecember2011was retrospectively reviewed and followed up， which werehospitalized patients，underwent surgery and confirmed by pathological， to analyzesurvival，draw survival curves by Kaplan-Meier method and analyze univariate andmultivariate prognostic factors by log-rank test/COX model，accessing to theirclinical features，pathological and immunohistochemical results and treatments.Results: All of the GISTs are170cases，accounting for1.49%of the same period inhospitalized patients with gastrointestinal tumor.91cases are male，79cases arefemale. The age is between23-84，the average age is55.12. The first symptom isgastrointestinal bleeding，accounting for36.47%.Tumors occur in the stomach，accounting for50.59%.CD117positive is a rate of97.06%，DOG1positive is a rateof98.26%.All patients underwent surgical treatment which R0resection of138cases(81.18%)，no surgery-related deaths. In the period of January2002to December2006，76cases of GISTs were followed up and5-year survival rate is53.9%.Univariate analysis by log-rank test shows: tumor location，tumor size，mitoticcount，tumor necrosis，significantly shaped of tumor cells，p53，Ki67，surgicalapproach，modified risk classification of NIH and oral Gleevec are prognostic factorsof GISTs. multivariate analysis by COX model shows：tumor size，significantlyshaped of tumor cells and surgical approach are the independent influencing factors.Conclusions: GISTs are the gastrointestinal mesenchymal tumors of malignantpotential，which is low incidence，occur in the stomach. R0resection is the preferredtreatment.Tumor size，significantly shaped of tumor cells and surgical approach arethe independent influencing factors of GISTs. To patients of R0resection，modifiedrisk classification of NIH is a good indicator for assessing the possibility ofrecurrence and prognosis. To patients of R1resection and R0resection of recurrence/metastasis，Gleevec can significantly improve the prognosis.