Analysis Of Clinicopathology And Prognostic Factors Of Patients With Gastrointestinal Stromal Tumor

Objective: To investigate the clinical and pathological features of gastrointestinalstromal tumor, with the therapeutic schedule, find out the relationship between thesesfactors and prognosisMethods: The clinical and pathological data of456patients with primary GISTs whowere admitted to the PLA General Hospital were retrospectively analyzed. All of themwere treated with surgery, relationship of clinical symptoms，pathological characteristicsand postoperative risk categories were analyzed.322patients were followed up, theprognostic factors were analyzed．Results: Of456GIST, male were259, female were197, median age was57years.247cases were stomach lesion,48cases were duodenum lesion,87cases were intestinallesion,18cases were colorectal lesion,48cases were out of gastrointestinal,3caseswere esophagus lesion,5cases were not found primary tumor. Of456GIST, abdominalpain，diarrhea，vomiting and discomfort were179, gastrointestinal bleeding were113,abdominal mass were89, asymptomatic were52, the others were23cases. Partialtraditional resection were283, lymph node dissection were42, extended resection were53, laparoscopic resection were64, endoscopic resection were7. Detection ofmetastases were57, tumor rupture were, CD117and CD34-positive were409，383,Ki67labelling index were determined by observing1000nuclei in areas of the sectionwith the highest labelling rates, and was considered positive when5%，10%or15%oftumor cells were stained, respectively，positive cases were180，129，116. Differentgrowth area had different positive rate of CD117, CD34, Ki67labelling index.Metastasis，neuromuscular differentiation，CD34，CD117，Ki67labelling index correlatewith NIH risk categories. Logistic regression analysis show that Ki67labelling indexdetermined by5%positive cell was the unique factor, which related to the NIH risk categories, P <0.05, RR=37.114,95%IC was1.061~6.167.322of GIST werefollowed up,70.6%of456, with an average follow-up time of51.55months,299treated with complete resection, incomplete resection were19,4could not be removeddue to infiltration of vital organs.54relapsed and33dead.103had treated with glivec.Tumor size, risk categories, Ki67labelling index were independent risk factors oflong-term recurrence-free survival；Tumor location, size, mitotic count, glivec therapybefore recurrence were independent risk factors of the short-term RFS; Risk categoriesgrade and Treatment Protocols were independent risk factors of long-term OS.Conclusions: Ki67labelling index determined by5%positive cell had clinicalsignificance, tumor size, risk categories grade, Ki67labelling index was an independentrisk factor of long-term rrecurrence-free survival, tumor location，size，mitotic count andGlivec therapy after complete resection were independent risk factor of the short-termRFS; Risk categories grade and Treatment Protocols were independent risk factors ofoverall survival for GIST after recurrence.