| Objective:Through retrospective analysis of the clinicopathological data of 395 patients with gastrointestinal stromal tumors,the clinical,pathological features and diagnosis and treatment characteristics of gastrointestinal stromal tumors were discussed,so as to provide more diagnosis and treatment basis for the diagnosis and treatment of gastrointestinal stromal tumors,and better serve the clinic.Methods:Clinical and pathological data of 395 GIST patients diagnosed by pathology at the First Affiliated Hospital of Gannan Medical University from June 1,2012 to June 30,2022 were collected,and statistical software SPSS 26.0 was used for statistical analysis to explore the relationship between the clinical and pathological features of GISTs and their prognosis,and P<0.05 was defined as statistically significant.Results:1.Of the 395 patients,174(44.1%)were male and 221(55.9%)were female.The age of onset ranged from 22 to 85 years old.Of all the patients,101(25.6%)were discovered through health examinations,171(43.3%)presented with abdominal pain,10(2.5%)with abdominal masses,6(1.5%)with changes in bowel habits,75(19.3%)with gastrointestinal bleeding,and29(7.1%)with other symptoms,(such as nausea and vomiting,dysphagia,weight loss,and limb weakness.)Among them,244 cases(61.5%)originated from the stomach,127 cases(33.2%)from the small intestine,18 cases(4.3%)from the rectum,and 6 cases(2.0%)from outside the gastrointestinal tract.2.All 395 patients underwent surgical treatment,among 78(19.7%)patients had an operation for endoscopic surgery,132(33.4%)for laparoscopic surgery,185(46.8%)for open surgery.After surgery,44 cases(11.1%)were diagnosed with tumor rupture and 119 cases(30.1%)showed local tumor infiltration.According to the National Institutes of Health(NIH)classification criteria,there were 65 cases(16.5%)in the very low-risk group,123 cases(31.4%)in the low-risk group,61 cases(15.4%)in the moderate-risk group,and 146 cases(36.7%)in the high-risk group.Postoperative pathology showed that there were 254 cases(63.4%)with a Ki-67 proliferation index of ≤5%,46 cases(11.6%)with 5-10%,44 cases(11.1%)with >10%,and51 cases(12.9%)where it was not detected;the number of mitotic figures was ≤5/50 high-power fields(HPF)in 343 cases(86.8%),5-10/50 HPF in 34 cases(8.6%),and >10/50 HPF in 18 cases(4.6%).3.Univariate analysis showed that gender,age,primary tumor site,surgical time,intraoperative blood loss,tumor maximum diameter,tumor local infiltration,tumor rupture status,nuclear division items,Ki-67 proliferation index,and modified NIH risk classification were statistically significant factors(P<0.05)for recurrence and death of gastrointestinal stromal tumors(GISTs).Multivariate COX regression analysis revealed that gender,age stratification,tumor local infiltration,and modified NIH risk classification were independent risk factors for GIST recurrence,while age stratification and nuclear division items were independent risk factors for death of GIST patients.4.Univariate analysis showed that gender,age,surgical type,surgical time,intraoperative blood loss,tumor diameter,tumor local infiltration,tumor rupture status,and postoperative targeted therapy were statistically significant factors(P<0.05)for prognosis of intermediate and high-risk GIST patients.Multivariate COX regression analysis revealed that gender,tumor local infiltration,and postoperative targeted therapy were independent risk factors for the prognosis of intermediate and high-risk GIST patients.5.The 1-year,3-year,and 5-year recurrence-free survival rates and overall survival rates of395 patients were 96%,88%,74%,and 96%,93%,87%,respectively."Conclusion:1.There was no significant difference in the incidence of gastrointestinal stromal tumors between men and women,and the age of onset was mostly concentrated in 45-74 years.2.Gender,age stratification,tumor local invasion,and modified NIH risk classification were independent risk factors affecting postoperative recurrence of GIST patients3.Age stratification and mitotic count were independent risk factors affecting the death of GIST patients.4.Gender,tumor local invasion,and whether to receive targeted therapy after surgery were independent risk factors for the prognosis of middle-and high-risk GIST patients. |
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