Pathological characteristics and prognosis of high risk gastrointestinal stromal tumors

doi:10.3877/cma.j.issn.1674-0793.2020.03.014

Abstract

Abstract:

Objective

To investigate the clinical characteristics and prognosis of high-risk gastrointestinal stromal tumors (GIST).

Methods

The clinical data of two hundred and forty-one high-risk GIST patients admitted to Leshan People’s Hospital from August 2009 to February 2016 were analyzed retrospectively.

Results

The proportion of men and women was 1.131. The age composition was mainly middle-aged and old people, and the proportion of people over 40 years old was 90.87% (219/241). The primary sites were stomach and small intestine, with 50 cases (20.75%) in stomach and 121 cases (50.21%) in small intestine. The first symptoms were mainly gastrointestinal symptoms, and the clinical manifestations were not typical. 232 patients (96.27%) underwent R0 resection and the recurrence and metastasis rate was 25.31% (61/241). The recurrence free survival rates of 1-, 3-, 5- year were 97.23%, 86.56% and 75.86%, respectively. The recurrence free survival time was (53.12±13.08) months. The tumor maximum diameter (RR=4.780, 95% CI: 3.716-6.052), mitotic image (RR=5.411, 95% CI: 2.195-7.119) were independent risk factors for 5-year recurrence free survival of high-risk GIST, while taking targeted drugs was the protective factor (RR=0.504, 95% CI: 0.288-0.883), the differences were statistically significant (P<0.001).

Conclusion

The clinical features of high-risk GIST are not obvious, and the prognosis is affected by mitotic image, the maximum diameter of the tumor and taking targeted drugs.

Key words: Gastrointestinal stromal tumors, Pathology, clinical, Prognosis, High-risk

Yaping Li, Mingjie Zhu, Hongyuan Jiang. Pathological characteristics and prognosis of high risk gastrointestinal stromal tumors[J]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(03): 222-225.

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References 21

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项目		例数	5年无复发生存率(%)	χ²值	P值
性别		?	?	1.903	0.087
?	男	128	54.87	?	?
?	女	113	55.62	?	?
年龄(岁)		?	?	0.281	0.311
?	≤50	82	67.38	?	?
?	> 50	159	63.45	?	?
肿瘤位置		?	?	0.287	0.342
?	胃	50	74.31	?	?
?	小肠	121	71.05	?	?
?	结直肠	41	41.16	?	?
?	胃肠外	29	59.62	?	?
肿瘤最大径(cm)		?	?	11.628	<0.001
?	7~15	153	74.06	?	?
?	>15	88	38.29	?	?
肿瘤性坏死		?	?	0.176	0.513
?	有	51	61.34	?	?
?	无	190	72.09	?	?
核分裂像(个/50HPF)		?	?	9.032	0.004
?	≤5	135	78.63	?	?
?	>5	106	57.39	?	?
肿瘤细胞类型		?	?	1.832	0.079
?	梭形细胞型	205	65.25	?	?
?	上皮样细胞型	21	73.42	?	?
?	混合型	15	77.16	?	?
DOG1		?	?	1.000	0.320
?	阳性	241	74.86	?	?
?	阴性	0	0	?	?
CD117		?	?	0.358	0.109
?	阳性	233	74.72	?	?
?	阴性	8	75.38	?	?
发病至确诊时间(d)		?	?	2.089	0.057
?	≤60	153	74.39	?	?
?	>60	88	60.13	?	?
手术根治性		?	?	1.764	0.301
?	R0	230	74.63	?	?
?	R1	7	75.89	?	?
?	R2	4	74.08	?	?
服用靶向药物		?	?	5.113	0.018
?	是	149	87.46	?	?
?	否	92	64.28	?	?

项目		例数	5年无复发生存率(%)	χ²值	P值
性别		?	?	1.903	0.087
?	男	128	54.87	?	?
?	女	113	55.62	?	?
年龄(岁)		?	?	0.281	0.311
?	≤50	82	67.38	?	?
?	> 50	159	63.45	?	?
肿瘤位置		?	?	0.287	0.342
?	胃	50	74.31	?	?
?	小肠	121	71.05	?	?
?	结直肠	41	41.16	?	?
?	胃肠外	29	59.62	?	?
肿瘤最大径(cm)		?	?	11.628	<0.001
?	7~15	153	74.06	?	?
?	>15	88	38.29	?	?
肿瘤性坏死		?	?	0.176	0.513
?	有	51	61.34	?	?
?	无	190	72.09	?	?
核分裂像(个/50HPF)		?	?	9.032	0.004
?	≤5	135	78.63	?	?
?	>5	106	57.39	?	?
肿瘤细胞类型		?	?	1.832	0.079
?	梭形细胞型	205	65.25	?	?
?	上皮样细胞型	21	73.42	?	?
?	混合型	15	77.16	?	?
DOG1		?	?	1.000	0.320
?	阳性	241	74.86	?	?
?	阴性	0	0	?	?
CD117		?	?	0.358	0.109
?	阳性	233	74.72	?	?
?	阴性	8	75.38	?	?
发病至确诊时间(d)		?	?	2.089	0.057
?	≤60	153	74.39	?	?
?	>60	88	60.13	?	?
手术根治性		?	?	1.764	0.301
?	R0	230	74.63	?	?
?	R1	7	75.89	?	?
?	R2	4	74.08	?	?
服用靶向药物		?	?	5.113	0.018
?	是	149	87.46	?	?
?	否	92	64.28	?	?

因素	β	SE(β)	Wald	P值	RR	95% CI
肿瘤最大径	1.914	0.204	8.029	<0.001	4.780	3.716~6.052
核分裂像	2.003	0.297	5.637	<0.001	5.411	2.195~7.119
服用靶向药物	-0.685	0.286	5.737	<0.001	0.504	0.288~0.883

因素	β	SE(β)	Wald	P值	RR	95% CI
肿瘤最大径	1.914	0.204	8.029	<0.001	4.780	3.716~6.052
核分裂像	2.003	0.297	5.637	<0.001	5.411	2.195~7.119
服用靶向药物	-0.685	0.286	5.737	<0.001	0.504	0.288~0.883

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