Current characteristics on small intestinal stromal tumor—a case control study

Lifang Zhao, Zhigang Zhao, Weidong Wang, Weiwei Zhao, Shengjun Tuo, Yupeng Shi, Wenlong Zhang, Ling Chen, Liu Hong, Jianjun Yang, Wei Lu, Qiong Wu, Jianhong Wang, Kaichun Wu


Background: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tract. Small intestine is the second most popular location of GIST, named small intestinal stromal tumor (SIST). The cumulative incidence of malignancy of SIST is twice that of gastric GIST. However, research studies on SIST are relatively rare.
Methods: The present retrospective study included 75 patients with SIST who underwent surgery resection and postoperative pathological diagnosis and analyzed the clinical manifestations, histopathological and immunohistochemical features, advantages and disadvantages of various auxiliary examinations, the treatment and prognosis of SIST.
Results: The number of Patients who had gastrointestinal bleeding was significantly higher than patients who had abdominal mass. Cases in the jejunum was significantly more than that in duodenum and ileum groups. With the increase of tumor diameter, the invasion risk also gradually increased. Patients with adverse outcome had bigger tumor diameter than patients with favorable outcome. For patients with adverse outcome, the nuclear division >5/50 HPF constitution is significantly higher than patients with favorable outcome. When categorized into 3 cell types according to cell morphology, the spindle-epithelioid cell type appeared only in patients with adverse outcome. Cox regression analysis indicated that tumor diameter 5.3 cm or higher and nuclear division > 5/50 can be independent risk factors for predicting SIST postoperative adverse outcome.
Conclusions: The present study analyzed the clinical statistics of SIST patients and improved the understanding of this disease and provided valid statistics for clinical diagnosis and treatment.