Contrast Study Of The Clinical, Pathological And Imaging On Gastrointestinal Stromal Tumor

Part?Clinicopathological Features of Gastrointestinal Stromal TumorObjective:To investigate the clinicopathological characteristic of gastrointestinal stromal tumors(GIST)occur in different parts.Methods: The clinical and imaging data of 164 patients who received surgery in Shanghai Xinhua Hospital from June 2008 to October 2015 and diagnosed as GIST were were retrospectively analyzed.Then compare the clinicopathological characteristic of GIST occur in stomach and small intestine.Results: A total of 164 GIST patients were collected,including 75 males and 89 females.The common symptoms of GIST include physical examination,abdominal pain or distension,gastrointestinal bleeding and abdominal mass.Most of the primary tumors are located in the stomach(127 cases),followed by the small intestine(27 cases).Six cases of tumor metastasis has occurred,eight cases associated with gastrointestinal cancer or precancerous lesions.The recurrence risk was very low in 47 cases,low in 50 cases,moderate in 24 cases and high in 37 cases.Clinicopathological analysis of gastric and small intestinal GIST of tumor size,tumor hemorrhage,necrosis and CD34 was significantly different(P <0.05).The maximum diameter of gastric GIST was much smaller than small intestinal GIST,necrosis probability of small intestinal GIST was higher than the gastric GIST,the CD34 expression positive rate was significantly lower in small intestinal GIST than gastric GIST.Conclusion: The common symptoms of GIST include physical examination,abdominal pain or distension,gastrointestinal bleeding.Most of the primary tumors are located in the stomach and small intestine.A few cases had liver metastases or associate with gastrointestinal cancer or precancerous lesions.The first symptom,tumor size,CD34-positive rate and hemorrhagic necrosis of the stomach and small intestine GIST exist probability differences.Part ?Correlation Analysis of CT Features and Ki67 Index or the Risk Stratification,CT Features of GIST in Different PartsObjective: To investigate the CT features of gastrointestinal stromal tumors,and explore the relationship with the CT features and Ki67 index or the risk stratification,then to evaluate the value of different CT features.Comparing the different CT features between gastric and small intestinal GIST.Material and methods: The clinical and imaging data of 121 patients who received CT examination and surgery in Shanghai Xinhua Hospital from October 2008 to December 2015 and diagnosed as GIST were were retrospectively analyzed.Using chi-square test,Pearson or rank correlation coefficient method for statistical analysis.Results: A total of 121 GIST patients were collected,including 83 gastric GISTs and 30 small intestinal GISTs.The recurrence risk was very low in 8 cases,low in 44 cases,moderate in 23 cases and high in 43 cases,three cases of tumor metastasis has occurred.In 121 cases,81 cases were in regular pattern,104 cases were well-defined,62 cases were extraluminal.There was ulceration in 26 cases,calcification in 14 cases,necrosis in 69 cases,87 cases were heterogeneous.The CT value was 33.3±4.7Hu on CT scan,the(35)CT value was 39.1±22.2Hu in venous phase.Ki67 index was highly positively correlated with the risk stratification,the correlation coefficients was 0.615.The size,shape,necrosis,boundary were correlated with Ki67 index,the correlation coefficients were 0.442,0.379,0.341,0.332,respectively.Necrosis,shape,tumor density,boundary were correlated with the risk stratification,the correlation coefficients were 0.549,0.495,0.478,0.444,respectively.The(35)CT value of small intestinal GISTs was greater than gastric GISTs.The size,growth pattern,necrosis,tumor density were discrepant between the GIST located in the upper and middle or lower parts.Conclusion : Ki67 index is an effective complementation in predicting the prognosis of GISTs.The lesion size,necrosis,and shape,boundary of GIST provide important basis for preoperative assessment.The enhancement degree of GIST in the stomach and small intestine shows significant differences.