Analysis of clinical diagnosis and treatment of 64 cases of small intestinal stromal tumor / 重庆医学

ABSTRACT

Objective To investigate small intestinal stromal tumors(SIST) of the clinical features,risk factors,diagnosis and treatment methods,and prognosis.Methods A retrospective analysis of clinical data and follow-up data of 56 SIST patients who had been confirmed by our department from December 2012 to August 2016.Results Of the 64 patients with SIST,45 were proximal small intestine (70.3％)and 19 were the distal small intestine (29.7 ％).The clinical manifestation of SIST is not typical,the first symptoms were digestive tract hemorrhage in 30 cases (46.9％),abdominal pain in 18 cases (28.1％),abdominal mass in 8 cases (12.5％),abdominal distention in 5 cases (7.8％),nausea and vomiting in 3 cases (4.7％).The detection rate of spiral CT for SIST was 98.2％ and the diagnostic coincidence rate of spiral CT for SIST was 57.9％,which was the highest in all the examinations.The postoperative pathological findings of 64 patients with SIST showed:8 cases of very low risk (12.5％),22 cases of low risk (34.4％),3 cases of moderate risk (4.7％) and 31 cases of high risk (48.4 ％％).There were differences in tumor diameter,mitotic figures,tumor risk and Ki-67 positive rate between the proximal and distal SIST(P＜0.05).The proximal SIST are less than equal to 5cm in diameter,and mitotic index less than equal to 5/50 high power field (HPF).The positive rate of Ki-67 in the proximal SIST is lower than that in the distal SIST.Tumor diameter,tumor nucleus mitotic counts,imatinib therapy and risk factors were correlated with SIST recurrence.Conclusion Gastrointestinal bleeding is the most common clinical manifestation of SIST and the incidence of proximal SIST is higher than that of distal SIST.Among the various methods of examination,spiral CT is the most effective means of inspection.The malignancy of the distal SIST is higher than that of the proximal SIST,and the distal SIST is more likely to relapse and metastasisthan the proximalSIST.