Clinicopathological Characteristics And Survival Analysis Of Metastatic Gastrointestinal Stromal Tumors At Different Metastatic Sites

Objective: To explore the clinicopathological features and survival analysis of metastatic gastrointestinal stromal tumors at different metastatic sites.Methods: Retrospectively collected the clinical data of 94 patients with liver metastasis or abdominal implant transfer from January 2009 to December 2016 in Fujian Medical University.According to their different metastatic sites,they were divided into liver metastasis group(41 cases)and abdominal implant transfer groups(53 cases).All the patients were analyzed by independent sample t-test,chi-square test and Logistic multivariate analysis to compare the clinical and pathological features of the two groups.The paraffin sections of 94 patients were immunohistochemically studied to study the difference of TGF?1,MMP-9 and VEGF-C expression in metastatic GIST tumor tissues.Kaplan-Meier method was used to investigate the differences of survival and poor prognostic factors of metastatic GIST in both groups.Results: 1.Correlation analysis showed that compared with the liver metastasis group,the diameter of the tumor in the abdominal pelvic implant metastasis group was larger(P<0.01),the tumor growth mode was more exogenous(P<0.05),and the tumor cell membrane invasion was more.(P<0.05),the proportion of patients with ascites was higher than that of liver metastasis group(P<0.01),multi-factor analysis of tumor diameter>10cm(P=0.009),intraoperative combined ascites(P=0.023)was independet of abdominal pelvic implant transfer.Risk factors.2.Immunohistochemical analysis showed that the positive rate of TGF?1 expression in paraffin-embedded tissues of patients with liver metastasis was higher(73.1% vs 58.5%)and the positive rate of MMP-9 expression was higher(63.4% vs 49.1).%),the positive rate of VEGF-C expression was higher(69.4% vs 62.3%).But the difference is not statistically significant.3.The overall survival rate of the two groups was shorter than that of the tumor diameter ?10cm in the tumor diameter >10cm group(P=0.021),and the overall survival time of the mitotic image>10/50 HPF group was shorter than the mitotic image ?10/50HPF(P=0.010).).The median survival time of 94 patients with metastatic GIST was 50 months.The overall survival time of the liver metastasis group was compared with that of the abdominal pelvic implant group.The median survival time of the liver metastasis group was 58 months,and the abdominal pelvic implant group was 47 months.Conclusion: Tumor diameter,exogenous growth pattern,serosal invasion and ascites are associated with abdominal pelvic implant metastasis;tumor diameter >10cm,intraoperative combined ascites is a risk factor for abdominal pelvic implant transfer;tumor diameter,mitotic image is metastatic GIST There was no significant difference in the overall survival of the liver metastasis group and the abdominal pelvic implant group.