Clinical Features Of Gastrointestinal Stromal Tumors And Analysis Of Therapeutic Effect Of Endoscopy And Surgery

Objective To summarize the clinical features of gastrointestinal stromal tumors(GIST),and to investigate the safety and feasibility of endoscopical therapy for gastric stromal tumors(d?2cm).Methods The study was divided into two parts: First,the clinical characteristics of gastrointestinal stromal tumors: 227 cases of gastrointestinal stromal tumors were diagnosed in patients admitted to the statistics.The characteristics of gastrointestinal stromal tumors were summarized by the patient's general information,clinical manifestations,pathology and immunization group.Second,digestive endoscopy and surgical efficacy comparison: 66 cases of digestive endoscopy or surgical resection of gastric stromal tumors(d ? 2cm)patients included in the statistics,and grouped into digestive endoscopy group(n = 24)and Surgical group(n = 42),endoscopic group including endoscopic mucosal dissection and endoscopic resection.The surgical group consisted of traditional open surgery and laparoscopic surgery,The perioperative period Data and follow-up results and other data for comparative analysis.ResultsFirst,the clinical characteristics of gastrointestinal stromal tumors1.General information In all GIST patients,male 100 and female 127,the average age of onset was 57.39 ± 11.37.The peak age of GIST was between 50-69 years old.There was no significant difference in the incidence of men and women.2.Clinical manifestations 53.7% of patients with abdominal pain or abdominal distension,22.9% found occasionally and 16.3% with bleeding,other rare clinical manifestations accounted for 7.1%.3.tumor characteristics GIST patients with an average diameter of 5.12 ± 4.16 cm,range from 0.8cm to 20.0cm.The primary tumors were located in the stomach(73.1%),small intestine(14.5%),esophagus(2.7%),duodenum(4.0%)and colorectal(5.7%).The positive rate of CD117 was 92.1%,and the positive rate of DOG-1 was 89.4%.The positive rate of DOG-1 expression in CD117-positive GIST was 91.4%,and the positive rate of DOG-1 expression in CD117-negative GIST was 30%.Second,endoscopy and surgical comparison of efficacy1.Perioperative related data The operation time was 126.7±52.4min in the surgery group and 36.9±11.5min in the endoscopy group.The postoperative feeding time was 3.6 ± 1.4 days in the surgery group and 1.6 ± 0.5 days in the endoscopy group.The postoperative hospital stay was 8.9 ± 2.6 days in the surgical group and 6.0 ± 3.6 days in the endoscopy group.The medical expenses was 40367.7 ± 12736.2 yuan in the surgery group and the endoscopy group was 23371.2 ± 10138.8 yuan.Above all the data between endoscopy and surgical were statistically different.2.Follow-up data The patients were followed up for 2-42 months.There was no loss of the patients in the digestive endoscopy group and 4 cases of the surgical group.No recurrence and death were observed during the follow-up period.Conclusion The clinical manifestations of gastrointestinal stromal tumor are not specific,and the tumor often occur in the 50-69 years old,there was no difference between men and women,the most common parts of the stomach and small intestine.DOG-1 can supplement the CDIST-negative GIST.The diameter of less than or equal to 2cm of gastrointestinal stromal tumors in patients with endoscopic surgery is safe and feasible compared with surgery.