Analysis of pathological features, clinic diagnosis and treatment of gastric stromal tumors

Abstract

Objective To investigate the clinic manifestations,pathological features,clinic diagnosis and treatment of gastric stromal tumors(GST).Methods The clinic data of 53 patients with GST in our unite from June 1996 to June 2006 were analyzed retrospectively.Results The major clinic signs of GST were upper gastrointestinal duct hemorrhage(28 cases,among whom 1 cases had abdominal mass),stomachache or abdominal distension(25 cases,among whom 3 cases had abdominal mass).All these patients,diagnosis relied on gastroduodenoscopy in 37 cases,on upper gastrointestinal tract barium X ray contrast examination in 25 cases,on CT in 33 cases,on B type ultrasound in 38 cases.Pathological examination proved that benign stromal tumor was 16 cases(30.2%),potential malignant types 8 cases(15.1%),and malignant types 29cases(53.9%).The tumor cells were mainly made up of spindle cell type in 18 cases,epithelial cell type in 11 cases,spindle cell and epithelial cell together in 23 cases.All of them were managed by operative treatment.Those patients whose tumor could not be resected completely(1 cases),recurrence(4 cases)or metastasis(1 cases)were managed by Imatinib mesylate.During follow-up from 1 year to 6 years,8 cases died of recurrence of GST,5 patients were part remission treating by Imatinib mesylatein in 15 GST recurrence patients post operation,29 patients survived today.Conclusions The main manifestations of GST are digestive duct hemorrhage or upper stomachache and abdominal distension.Gastroduodenoscopy and upper gastrointestinal tract barium X ray contrast examination are main diagnosis choice for these patients of GST.Malignant GST is the most common pathological types.The GST tumor cells are mainly made up of spindle cell type,epithelial cell type or spindle cell and epithelial cell together.Operative treatment is thought of the first choice.Imatinib mesylate has rather better clinical effect for those patients with GST not being able to be excised completely or recurrence post-operation. Key words: Gastric stromal tumor; Imatinib mesylate; Gastroduodenoscopy; Upper gastrointestinal tract barium X ray contrast examination:Pathological features