| Objective: to investigate the clinicopathologic features and prognostic factors of gastric stromal tumor(GST).Some inflammatory biomarkers(such as NLR,PNI,LMR,etc.)can be used to evaluate the prognosis of patients with malignant tumors.Fibrinogen is associated with prognosis of tumors,especially malignant tumors,including non-small cell lung cancer,breast cancer(her2 positive),liver cancer,and malignant lymphoma.To explore the prognostic value of FIB and NLR in patients with gastric stromal tumor.Materials and methods: We collected the clinical data of 116 patients with gastric stromal tumor treated by surgical resection in the First Affiliated Hospital of China Medical University from July 2005 to December 2016.Then we retrospectively analyzed the clinical data of patients with gastric stromal tumors,auxiliary examination that endoscopy,EUS,enhanced CT,MRI and other test results.At last,we use the single factor analysis to compare the effects of gender,age,tumor size,mitotic image,risk grade and other factors on the prognosis of patients.Results:1.General situation: from May 2005 to December 2016,116 cases of gastric stromal tumors were treated surgically,including 53 males and 63 females.The male to female ratio was 1:1.19,the age ranged from 21 to 82 years,with a median age of59.5 years.2.Clinical manifestations: The group of 116 patients,the patient admitted to the hospital for the main indicators of statistical indicators,mainly in patients with upper gastrointestinal bleeding in 25 cases,accounting for 21.56%;36 cases of complaints of abdominal discomfort,accounting for 31.03%;physical findings were 26 Cases accounted for 22.41%;nausea,vomiting,acid reflux and other main complaints of hospitalized patients in 7 cases,accounting for 6.03%;acute abdomen in patients with2 cases,accounting for 1.72%;other such as defecation change,weight loss,accounting for 6.90%;3.Auxiliary examination: Gastroscopy in this group of 89 patients,the detection rate was 71.91%;ultrasound gastroscopy of 43 cases,the detection rate was 93.02%,the main manifestation of the elevation changes;abdominal enhanced CT of 79 cases,the detection rate was 63.29%;the main Prompted enhancement of the nodules of the abdomen can be seen enhanced,enhanced 22-84 Hu range;MRI examination of 8cases,the detection rate was 62.50%;abdominal ultrasound occasionally prompted abdominal mass;4.Pathology and immunohistochemistry: According to the NIH classification,116 patients were classified as extremely low risk(5,4.31%),low risk(48,41.38%),intermediate risk(27,23.28%)and high risk(36,31.03%).Immunohistochemistry results showed that CD117 was positive in 71/73(97.26%),DOG-1 was positive in67/69(97.10%),and CD34 positive in 69/70(98.57%).5.Follow-up: the follow-up time of 116 patients was 2-118 months,and the median follow-up time was 32 months.During the follow-up period,11 patients died and 8died from recurrence and metastasis.9 cases were missed and the follow-up rate was92.24%.Conclusion:1.Gastric stromal tumors can occur at any age and the age of 45-75 is the peak age.There is no significant difference in the incidence of male and female.2.The clinical manifestations of stromal tumors are nonspecific.Clinical diagnosis is mainly based on ultrasonic gastroscopy.The diagnostic rate is significantly higher than that of abdominal enhanced CT and other auxiliary examinations.The diagnosis mainly depends on pathology and immunohistochemistry.3.For primary resectable GST,surgery should pursue a complete resection of the tumor with negative marginal tissue,and adhere to all surgical excision principles,including tumor pseudocapsules and avoidance of tumor dissemination.Imatinib can be considered as the first choice for unresectable or metastatic GIST.4.NIH classification,tumor diameter,mitotic figure and NLR ratio were significantly correlated with GST prognosis,and were independent factors affecting GST.FIB value was significantly correlated with NIH classification,which may affect the prognosis of GST patients. |
PDF Full Text Request