1.Clinical cases and prognosis analysis of primary gastrointestinal stromal tumors
Licheng LIU ; Xin WU ; Wentong XU
Chinese Journal of Digestion 2013;(3):150-154
Objective To analyze the clinical characters,therapeutic effect of gastrointestinal stromal tumors (GIST),the effects of surgical approach and imatinib adjuvant therapy on it.Methods From January 2004 to April 2010,the clinical data of 214 patients with primary GIST were retrospectively analyzed.The effects of surgical approach and imatinib on the survival of the GIST patients were compared.Count data were analyzed by chi-square test,and the survival rates were analyzed with the life table method and Kaplan-Meier curve.Results A total of 214 GIST patients'survival rates of 1-year,3-year,5-year were 93.0%,87.0% and 80.0%.According to the risk classification of National Institutes of Health,the differences of overall survival rates after surgery were statistically significant (x2 =22.058,P<0.05).The differences of survival rate among different nuclear division number were statistically significant (x2=26.599,P<0.05).The survival rate of pathological nuclear division number over 10/50 high power field (HPF) was the lowest.The overall survival rate of patients with gastrointestinal GIST was higher than patients with extragastrointestinal GIST,and the difference was statistically significant (x2 =68.139,P < 0.05).After complete resection of the tumor,the survival rate of patients with local recurrence was higher than those with widely recurrence,and the difference was statistically significant (x2 =4.409,P< 0.05).After complete resection of the tumor,the survival rate of patients taking imatinib was higher than that of patients not taking imatinib.Conclusions The surgical treatment was the main therapy for GIST.Complete resection of the tumor and taking imatinib after surgery could improve the prognosis and the survival rate of the GIST patients.
2.Prognotic analysis of 132 cases with gastrointestinal stromal tumors
Peng LI ; Licheng LIU ; Xin WU ; Wentong XU
Cancer Research and Clinic 2014;26(1):48-51
Objective To analyze the survival rates of gastrointestinal stromal tumors (GISTs),and the influence of surgical treatment and imatinib to the survival times.Methods The clinical data of 132 patients with GIST who were admitted to Peoples Liberation Army Hospital from January 2003 to December 2013 were retrospectively analyzed.Results All the patients were followed up with a median time of 22 months (1-83 months).The survival rates of 1-year,3-year,5-year were 99 %,96 %,92 % in this study.The tumor located at cardiac part,fundus of stomach,greater curvature,lesser curvature and pylorus part was 19 cases (14.4 %),34 cases (25.8 %),38 cases (28.8 %),38 cases (28.8 %) and 3 cases (2.3 %),respectively.The positive rates of CD117,CD34 and Ki-67 was 116 cases (87.9 %),119 cases (90.2 %),51 cases (38.6 %).According to Fletcher risk classification,the patients of high-low risk,low risk,intermediate risk,and high risk were 10 cases (7.6 %),34 cases (25.8 %),14 cases (10.6 %),and 74 cases (56.1%),respectively.The differences of survive rates in the different excision method and imatinib treatment had statistics significance (P =0.000).The differences of survive rates in Fletcher risk classification had statistics significance (P =0.028).However,the differences of survive rates in location of gastric GIST showed no significant difference (P > 0.05).Conclusions GIST in different parts of gastric have not obviously different survival rates,respectively.The total resection and imatinib treatment could raise the survival rates of patients with GIST.
3.Effects of silencing TGF-β1 by RNAi on Smads signal transduction of rat renal allograft
Yuguo XIA ; Wentong ZENG ; Guangsen LI ; Ping GAO ; Yonghua ZHANG ; Tianlang WU
Chinese Journal of Organ Transplantation 2011;32(6):358-362
Objective To evaluate the effects of shRNA-TGF-β1 plasmid on Smads signal transduction of rat renal allograft.Methods A Sprague-Dawley to Wistar rat orthotopic transplant kidney-sclerosis accelerated model was constructed and transfected with short hairpin RNA-TGF-β1 based on the hydromechanics.The recipients were divided into three groups:group T(plasmid group)injected with shRNA-TGF-β1;group H(vacant plasmid group)injected with vacant plasmid;group Y(simply transplantation group)injected with no plasmid.In group J(sham-operated group)only right kidney was removed with no transplantation as control group.Transplanted kidneys and blood samples were collected at the first,second and third month after transplantation.The blood urea nitrogen(BUN)and serum Cr were tested by enzyme-linked immunoadsordent assay.The gene transcriptional level of TGF-β1 and Smad3/7 was detected by RT-PCR,and the protein variations of TGF-β1 and phosphorylated Smad3/7 were examined by Western blotting.Results At each test time point,the BUN and serum Cr were significantly higher in the plasmid group than in the sham-operated group(P<0.05 or P<0.01),but obviously lower than in the vacant plasmid group and simply transplantation group(P<0.05 or P<0.01).The expression of TGF-β1 as well as phosphorylated Smad3 was significantly higher in the plasmid group than in the sham-operated group(P<0.05 or P<0.01),but obviously lower than in the vacant plasmid group and simply transplantation group(P<0.05 or P<0.01).However,the expression of phosphorylated Smad7 was significantly lower in the plasmid group than in the sham-operated group(P<0.05 or P<0.01),but obviously higher than in the vacant plasmid group and simply transplantation group(P<0.05 or P<0.01).Conclusion Short hairpin RNA-TGF-β1 plasmid could significantly improve the renal function of rat renal allografts probably by downregulating phosphorylated Smad3 and upregulating phosphorylated Smad7,leading to the inhibition of TGF-beta 1 promoting fibrosis role and delay of the allograft fibrosis.
4.Changes of the metabolism of anti-oxidation competence of endothelial cells induced from mesenchymal stem cells after fluid shear stress loading.
Siyuan YANG ; Yingkang SHI ; Changxue WU ; Ke DIAN ; Jiang WU ; Wentong MENG ; Yuchun WANG
Journal of Biomedical Engineering 2008;25(3):616-620
This study examined the effects of flow shear stress on the bio-capacity of the endothelial cells' induced from mesenchymal stem cells (MSCs). After cultivating the SD rat mesenchymal stem cells in vitro, we exposed them under different intensity of flow shear stress and induced these cells to endothelial cells. The variations of total anti-oxidation competence (T-AOC) and quantity of nitrogen monoxide (NO) were tested. The results showed that shear stress has an enhanced effect on the T-AOC and NO of endothelial cells induced from MSCs in an intensity-dependent manner. Flow shear stress could provide a protective action on the in vitro induction of endothelial cells, thus formulating a theoretical foundation for the therapeutics of ischemic heart diseases and vascular tissue engineering.
Animals
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Antioxidants
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metabolism
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Bone Marrow Cells
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cytology
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physiology
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Cell Differentiation
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physiology
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Cells, Cultured
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Endothelial Cells
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cytology
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metabolism
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Female
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Male
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Mesenchymal Stromal Cells
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cytology
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physiology
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Oxidation-Reduction
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Rats
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Rats, Sprague-Dawley
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Stress, Mechanical
5.Efficacy and prognosis of different treatments on 63 patients with small intestinal gastrointestinal stromal tumors.
Licheng LIU ; Yagang LIU ; Xin WU ; Lin CHEN ; Wentong XU
Chinese Journal of Gastrointestinal Surgery 2014;17(4):344-347
OBJECTIVETo analyze the efficacy and prognosis of different treatments on small intestinal gastrointestinal stromal tumors(SIGIST).
METHODSClinical data of 63 patients with SIGIST who were admitted to the Chinese PLA General Hospital from January 2004 to December 2013 were analyzed retrospectively. According to resection procedure and postoperative use of imatinib, patients were divided into R0 resection plus imatinib group (13 cases), R0 resection without imatinib group (42 cases), non-R0 resection plus imatinib group (7 cases), non-R0 resection without imatinib group (1 case). Survival was compared among groups. Result All the patients were followed up with a median length of 24 months(3 to 120 months), and the over survival (OS) rates at 1-year, 3-year, 5-year were 97%, 94% and 80%. In R0 resection plus imatinib group, R0 resection without imatinib group, and non-R0 resection plus imatinib group, the progression free survival(PFS) time was 24, 24 and 23 months; the 1-year PFS were 100%, 97% and 83%; the 3-year PFS were 100%, 45% and 83%; the 5-year PFS were 100%, 28% and 42%. R0 resection plus imatinib group had significantly higher PFS(all P<0.05). The case of non-R0 resection without imatinib died 6 months after operation. Among 55 patients undergoing R0 resection, recurrence was found in 16 patients, whose recurrence rates of 1-year, 3-yeart and 5-year were 2%,43% and 58%. Local recurrence was found in 8 cases, hepatic recurrence in 3 cases and widespread recurrence in 5 cases, who received simple imatinib, operation plus imatinib and imatinib intervention, with median survival time of 66.5 months, 92.5 months and 48 months respectively. One patient initiatively abandoned treatment and died 17 months later.
CONCLUSIONThe total resection and postoperative imatinib administration can improve the prognosis and raise the progression free survival of patients with small intestinal stromal tumors.
Antineoplastic Agents ; therapeutic use ; Benzamides ; therapeutic use ; Disease-Free Survival ; Gastrointestinal Stromal Tumors ; drug therapy ; surgery ; Humans ; Imatinib Mesylate ; Intestinal Neoplasms ; drug therapy ; pathology ; surgery ; Intestine, Small ; pathology ; Neoplasm Recurrence, Local ; Piperazines ; therapeutic use ; Prognosis ; Pyrimidines ; therapeutic use ; Retrospective Studies
6.Analysis on the factors that affect the therapeutic effects of endoscopic radiofrequency ablation on gastroesophageal reflux disease
Quanbin PENG ; Wentong WU ; Yiping HONG ; Meirong LIU ; Jian HUANG
Chinese Journal of Primary Medicine and Pharmacy 2021;28(9):1338-1342
Objective:To investigate the factors that affect the therapeutic effects of endoscopic radiofrequency ablation (Stretta procedure) on gastroesophageal reflux disease (GERD).Methods:Seventy patients with gastroesophageal reflux disease who received endoscopic radiofrequency ablation (Stretta procedure) treatment in Jinhua Hospital of Traditional Chinese Medicine from January 2016 to January 2019 were included in this study. They were divided into good prognosis group ( n = 57) and poor prognosis group ( n = 13) according to prognostic effects. The clinical data of all patients were collected, including gender, age, body mass index (BMI), course of disease, complications (hypertension, coronary heart disease, diabetes), smoking, drinking, Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores. Unconditional stepwise logistic regression was performed to analyze the factors that affect the therapeutic effects of Stretta procedure on GERD. Results:Univariate analysis results revealed that the proportion of patients aged ≥ 60 years with BMI ≥ 25 kg/m 2, alcohol abuse, HAMD score ≥ 8, HAMD score ≥ 7 was significantly higher in the poor prognosis group than in the good prognosis group ( χ2 = 9.574, 10.821, 22.575, 8.653, 10.586, 4.070, 8.653, all P < 0.05). Logistic regression analysis confirmed that female gender, age ≥ 60 years, BMI ≥ 25 kg/m 2, course of disease ≥ 5 years, alcohol abuse, HAMD score ≥ 8 and HAMA score ≥ 7 were the risk factors for poor prognosis of gastroesophageal reflux disease ( χ2 = 11.174, 6.023, 8.698, 5.972, 5.821, 7.485, 5.443, all P < 0.05). Consistency analysis revealed that gender, age, BMI, course of disease, alcohol abuse, HAMD score and HAMA score could be used to predict the therapeutic effects of endoscopic radiofrequency ablation (Stretta procedure) on GERD. Combined application of gender, age, BMI, course of disease, alcohol abuse, HAMD score and HAMA score exhibited higher consistency than a single application, 0.827 > 0.577, 0.533, 0.795, 0.547, 0.606, 0.434 and 0.547. Conclusion:There are many factors that affect the therapeutic effects of endoscopic radiofrequency ablation (Stretta procedure) on GERD, including gender, age, BMI, course of disease, alcohol abuse, HAMD score and HAMA score. This is of certain reference value for clinical treatment of GERD, and combined application of these influential factors has a high accuracy in the prediction of the therapeutic effects of Stretta procedure on GERD.
7.Efficacy and prognosis of different treatments on 63 patients with small intestinal gastrointestinal stromal tumors
Licheng LIU ; Yagang LIU ; Xin WU ; Lin CHEN ; Wentong XU
Chinese Journal of Gastrointestinal Surgery 2014;(4):344-347
Objective To analyze the efficacy and prognosis of different treatments on small intestinal gastrointestinal stromal tumors (SIGIST). Methods Clinical data of 63 patients with SIGIST who were admitted to the Chinese PLA General Hospital from January 2004 to December 2013 were analyzed retrospectively. According to resection procedure and postoperative use of imatinib, patients were divided into R0 resection plus imatinib group (13 cases), R0 resection without imatinib group (42 cases), non-R0 resection plus imatinib group (7 cases), non-R0 resection without imatinib group (1 case). Survival was compared among groups. Result All the patients were followed up with a median length of 24 months(3 to 120 months), and the over survival (OS) rates at 1-year, 3-year, 5-year were 97%, 94% and 80%. In R0 resection plus imatinib group, R0 resection without imatinib group, and non-R0 resection plus imatinib group, the progression free survival (PFS) time was 24, 24 and 23 months; the 1-year PFS were 100%, 97% and 83%; the 3-year PFS were 100%, 45% and 83%; the 5-year PFS were 100%, 28% and 42%. R0 resection plus imatinib group had significantly higher PFS (all P<0.05). The case of non-R0 resection without imatinib died 6 months after operation. Among 55 patients undergoing R0 resection, recurrence was found in 16 patients, whose recurrence rates of 1-year, 3-yeart and 5-year were 2%,43% and 58%. Local recurrence was found in 8 cases, hepatic recurrence in 3 cases and widespread recurrence in 5 cases , who received simple imatinib , operation plus imatinib and imatinib intervention, with median survival time of 66.5 months, 92.5 months and 48 months respectively. One patient initiatively abandoned treatment and died 17 months later. Conclusion The total resection and postoperative imatinib administration can improve the prognosis and raise the progression free survival of patients with small intestinal stromal tumors.
8.Efficacy comparison between laparoscopy and open surgery in the treatment of gastric gastrointestinal stromal tumors larger than 2 cm using multicenter propensity score matching method
Xin WU ; Linde SUN ; Ming WANG ; Peng ZHANG ; Zelong YANG ; Han LIANG ; Kaixiong TAO ; Hui CAO ; Wentong XU
Chinese Journal of Gastrointestinal Surgery 2020;23(9):888-895
Objective:To compare the efficacy between laparoscopy and open surgery for gastric gastrointestinal stromal tumor (GIST) larger than 2 cm.Methods:A multicenter retrospective cohort study was performed. Inclusion criteria: long diameter of primary gastric GIST > 2 cm; undergoing laparoscopy or open surgery; diagnosis confirmed by postoperative pathology without distant metastasis; without preoperative targeted therapy. Clinicopathological data of 857 gastric GIST patients, including 320 in PLA General Hospital, 284 in Shanghai Renji Hospital, 175 in Wuhan Union Hospital and 78 in Tianjin Cancer Hospital, from January 2010 to May 2017 were retrospectively collected. There were 418 males and 439 females, mainly aged between 50 and 70 years old. Among 857 patients, 413 were in the laparoscopy group and 444 in the open group. The nearest neighbor matching of propensity score matching method was conducted with 1:1 matching based on tumor location and size between laparoscopy and open group to obtain samples of covariate equilibrium, and the caliper value was 0.04. The t test, χ 2 test and Wilcoxon rank test were used to compare short-term efficacy, and the Kaplan-Meier curve and log rank test were applied to compare long-term outcomes between the two groups. Results:After propensity score matching, laparoscopy group and open group both enrolled 293 cases. The baseline data, including age, gender, tumor location, tumor long diameter, NIH classification, etc. were not significantly different between the two groups (all P>0.05). Compared with the open group, the laparoscopy group had less intraoperative blood loss [<100 ml: 2.9% (155/293) vs. 36.2% (106/293), Z=-12.857, P<0.001], shorter time to postoperative feeding [(4.0±0.2) days vs. (5.3±0.9) days, t=1.505, P=0.003] and to the removal of drainage tube [(4.8±1.0) days vs. (6.5±1.0) days, t=1.847, P=0.008], and shorter postoperative hospital stay [(8.6±0.3) days vs. (10.5±0.3) days, t=4.235, P<0.001]. Subgroups analysis according to anatomical location: (1) Gastric cardia and pylorus: there were no statistically significant differences in perioperative parameters between the two groups (all P>0.05). (2) Stomach base: feeding time after surgery [(4.0±0.2) days vs. (4.5±0.2) days, t=0.512, P=0.038], drainage tube removal time [(5.1±0.4) days vs. (6.4±0.6) days, t=0.517, P=0.044], postoperative hospital stay [(8.0±0.5) days vs. (11.1±0.9) days, t=0.500, P=0.002] were all significantly shorter in the laparoscopy group as compared to the open group, while the differences in other perioperative parameters were not statistically significant (all P>0.05). (3) Lesser curvature of the stomach: the laparoscopy group had less intraoperative blood loss [<100 ml ratio: 58.1% (43/74) vs. 33.7% (25/74), Z=7.632, P=0.034], shorter gastric tube removal time [(2.7±0.2) days vs. (3.2±0.3) days, t=0.503, P=0.007], earlier postoperative passage of gas [(2.8±0.1) days vs. (3.4±0.2) days, t=0.532, P=0.030], earlier postoperative feeding [(3.6±0.2) days vs. (4.3±0.2) days, t=0.508, P=0.020], shorter drainage tube removal time [(4.2±0.4) days vs. (5.7±0.5) days, t=0.508, P=0.020] and postoperative hospital stay [(8.3±0.6) days vs. (10.7±0.3) days, t=0.502, P=0.006] as compared to the open group. (4) Great curvature of the stomach: the laparoscopy group presented less intraoperative blood loss [<100 ml ratio: 52.7% (39/74) vs. 36.5% (27/74), Z=7.681, P=0.032], earlier gastric tube removal [(2.6±0.2) days vs. (3.6±0.2) days, t=0.501, P=0.001], earlier postoperative passage of gas [(2.7±0.2) days vs. (3.4±0.2) days, t=0.501, P=0.016], earlier postoperative feeding [(3.6±0.2) days vs. (4.7±0.2) days, t=0.500, P=0.001], shorter drainage tube removal time [(4.0±0.5) days to (5.9±0.4) days, t=0.508, P=0.002] and postoperative hospital stay [(7.5±0.3) days to (9.5±0.1) days, t=0.500, P=0.001] than the open group. Subgroup analysis according to tumor size: (1) Tumor long diameter 2.0-5.0 cm: the laparoscopy group had earlier passage of gas [(2.9±0.1) days vs. (3.5±0.1) days, t=0.500, P=0.001], earlier postoperative feeding [(4.5±0.1) days vs. (5.0±0.2) days, t=0.501, P=0.013], shorter drainage tube removal time [(4.8±0.3) days vs. (6.0±0.3) days, t=0.511, P=0.008] and postoperative hospital stay [(8.1±0.4) days to (10.1±0.3) days, t=0.513, P=0.001] than the open group. (2) Tumor long diameter 5.1-10.0 cm: in the laparoscopic group, postoperative feeding time [(4.0±0.2) days vs. (4.7±0.2) days, t=0.506, P=0.015], drainage tube removal time [(4.6±0.4) days vs. (6.4±0.5)) days, t=0.501, P=0.004], postoperative hospital stay [(8.2±0.3) days vs. (10.9±0.6) days, t=0.500, P=0.001] were all shorter than those in the open group. No intraoperative and postoperative complications were observed in each group. The 5-year recurrence-free survival rates of the laparoscopy group and the open group were 95.4% and 91.6%, respectively ( P=0.734), and the 5-year overall survival rates were 93.8% and 90.8% ( P=0.691), respectively, and the differences were not statistically significant. Conclusions:In experienced medical centers, laparoscopic surgery for gastric GIST larger than 2 cm is safe and feasible, and can achieve comparable efficacy with open surgery. For gastric GISTs which do not locate in the greater curvature and the anterior wall of the stomach, and whose long diameter is ≤5 cm, laparoscopic surgery does not increase the risk of recurrence and metastasis, and can accelerate postoperative recovery.
9.Efficacy and prognosis of different treatments on 63 patients with small intestinal gastrointestinal stromal tumors
Licheng LIU ; Yagang LIU ; Xin WU ; Lin CHEN ; Wentong XU
Chinese Journal of Gastrointestinal Surgery 2014;(4):344-347
Objective To analyze the efficacy and prognosis of different treatments on small intestinal gastrointestinal stromal tumors (SIGIST). Methods Clinical data of 63 patients with SIGIST who were admitted to the Chinese PLA General Hospital from January 2004 to December 2013 were analyzed retrospectively. According to resection procedure and postoperative use of imatinib, patients were divided into R0 resection plus imatinib group (13 cases), R0 resection without imatinib group (42 cases), non-R0 resection plus imatinib group (7 cases), non-R0 resection without imatinib group (1 case). Survival was compared among groups. Result All the patients were followed up with a median length of 24 months(3 to 120 months), and the over survival (OS) rates at 1-year, 3-year, 5-year were 97%, 94% and 80%. In R0 resection plus imatinib group, R0 resection without imatinib group, and non-R0 resection plus imatinib group, the progression free survival (PFS) time was 24, 24 and 23 months; the 1-year PFS were 100%, 97% and 83%; the 3-year PFS were 100%, 45% and 83%; the 5-year PFS were 100%, 28% and 42%. R0 resection plus imatinib group had significantly higher PFS (all P<0.05). The case of non-R0 resection without imatinib died 6 months after operation. Among 55 patients undergoing R0 resection, recurrence was found in 16 patients, whose recurrence rates of 1-year, 3-yeart and 5-year were 2%,43% and 58%. Local recurrence was found in 8 cases, hepatic recurrence in 3 cases and widespread recurrence in 5 cases , who received simple imatinib , operation plus imatinib and imatinib intervention, with median survival time of 66.5 months, 92.5 months and 48 months respectively. One patient initiatively abandoned treatment and died 17 months later. Conclusion The total resection and postoperative imatinib administration can improve the prognosis and raise the progression free survival of patients with small intestinal stromal tumors.
10.Efficacy comparison between laparoscopy and open surgery in the treatment of gastric gastrointestinal stromal tumors larger than 2 cm using multicenter propensity score matching method
Xin WU ; Linde SUN ; Ming WANG ; Peng ZHANG ; Zelong YANG ; Han LIANG ; Kaixiong TAO ; Hui CAO ; Wentong XU
Chinese Journal of Gastrointestinal Surgery 2020;23(9):888-895
Objective:To compare the efficacy between laparoscopy and open surgery for gastric gastrointestinal stromal tumor (GIST) larger than 2 cm.Methods:A multicenter retrospective cohort study was performed. Inclusion criteria: long diameter of primary gastric GIST > 2 cm; undergoing laparoscopy or open surgery; diagnosis confirmed by postoperative pathology without distant metastasis; without preoperative targeted therapy. Clinicopathological data of 857 gastric GIST patients, including 320 in PLA General Hospital, 284 in Shanghai Renji Hospital, 175 in Wuhan Union Hospital and 78 in Tianjin Cancer Hospital, from January 2010 to May 2017 were retrospectively collected. There were 418 males and 439 females, mainly aged between 50 and 70 years old. Among 857 patients, 413 were in the laparoscopy group and 444 in the open group. The nearest neighbor matching of propensity score matching method was conducted with 1:1 matching based on tumor location and size between laparoscopy and open group to obtain samples of covariate equilibrium, and the caliper value was 0.04. The t test, χ 2 test and Wilcoxon rank test were used to compare short-term efficacy, and the Kaplan-Meier curve and log rank test were applied to compare long-term outcomes between the two groups. Results:After propensity score matching, laparoscopy group and open group both enrolled 293 cases. The baseline data, including age, gender, tumor location, tumor long diameter, NIH classification, etc. were not significantly different between the two groups (all P>0.05). Compared with the open group, the laparoscopy group had less intraoperative blood loss [<100 ml: 2.9% (155/293) vs. 36.2% (106/293), Z=-12.857, P<0.001], shorter time to postoperative feeding [(4.0±0.2) days vs. (5.3±0.9) days, t=1.505, P=0.003] and to the removal of drainage tube [(4.8±1.0) days vs. (6.5±1.0) days, t=1.847, P=0.008], and shorter postoperative hospital stay [(8.6±0.3) days vs. (10.5±0.3) days, t=4.235, P<0.001]. Subgroups analysis according to anatomical location: (1) Gastric cardia and pylorus: there were no statistically significant differences in perioperative parameters between the two groups (all P>0.05). (2) Stomach base: feeding time after surgery [(4.0±0.2) days vs. (4.5±0.2) days, t=0.512, P=0.038], drainage tube removal time [(5.1±0.4) days vs. (6.4±0.6) days, t=0.517, P=0.044], postoperative hospital stay [(8.0±0.5) days vs. (11.1±0.9) days, t=0.500, P=0.002] were all significantly shorter in the laparoscopy group as compared to the open group, while the differences in other perioperative parameters were not statistically significant (all P>0.05). (3) Lesser curvature of the stomach: the laparoscopy group had less intraoperative blood loss [<100 ml ratio: 58.1% (43/74) vs. 33.7% (25/74), Z=7.632, P=0.034], shorter gastric tube removal time [(2.7±0.2) days vs. (3.2±0.3) days, t=0.503, P=0.007], earlier postoperative passage of gas [(2.8±0.1) days vs. (3.4±0.2) days, t=0.532, P=0.030], earlier postoperative feeding [(3.6±0.2) days vs. (4.3±0.2) days, t=0.508, P=0.020], shorter drainage tube removal time [(4.2±0.4) days vs. (5.7±0.5) days, t=0.508, P=0.020] and postoperative hospital stay [(8.3±0.6) days vs. (10.7±0.3) days, t=0.502, P=0.006] as compared to the open group. (4) Great curvature of the stomach: the laparoscopy group presented less intraoperative blood loss [<100 ml ratio: 52.7% (39/74) vs. 36.5% (27/74), Z=7.681, P=0.032], earlier gastric tube removal [(2.6±0.2) days vs. (3.6±0.2) days, t=0.501, P=0.001], earlier postoperative passage of gas [(2.7±0.2) days vs. (3.4±0.2) days, t=0.501, P=0.016], earlier postoperative feeding [(3.6±0.2) days vs. (4.7±0.2) days, t=0.500, P=0.001], shorter drainage tube removal time [(4.0±0.5) days to (5.9±0.4) days, t=0.508, P=0.002] and postoperative hospital stay [(7.5±0.3) days to (9.5±0.1) days, t=0.500, P=0.001] than the open group. Subgroup analysis according to tumor size: (1) Tumor long diameter 2.0-5.0 cm: the laparoscopy group had earlier passage of gas [(2.9±0.1) days vs. (3.5±0.1) days, t=0.500, P=0.001], earlier postoperative feeding [(4.5±0.1) days vs. (5.0±0.2) days, t=0.501, P=0.013], shorter drainage tube removal time [(4.8±0.3) days vs. (6.0±0.3) days, t=0.511, P=0.008] and postoperative hospital stay [(8.1±0.4) days to (10.1±0.3) days, t=0.513, P=0.001] than the open group. (2) Tumor long diameter 5.1-10.0 cm: in the laparoscopic group, postoperative feeding time [(4.0±0.2) days vs. (4.7±0.2) days, t=0.506, P=0.015], drainage tube removal time [(4.6±0.4) days vs. (6.4±0.5)) days, t=0.501, P=0.004], postoperative hospital stay [(8.2±0.3) days vs. (10.9±0.6) days, t=0.500, P=0.001] were all shorter than those in the open group. No intraoperative and postoperative complications were observed in each group. The 5-year recurrence-free survival rates of the laparoscopy group and the open group were 95.4% and 91.6%, respectively ( P=0.734), and the 5-year overall survival rates were 93.8% and 90.8% ( P=0.691), respectively, and the differences were not statistically significant. Conclusions:In experienced medical centers, laparoscopic surgery for gastric GIST larger than 2 cm is safe and feasible, and can achieve comparable efficacy with open surgery. For gastric GISTs which do not locate in the greater curvature and the anterior wall of the stomach, and whose long diameter is ≤5 cm, laparoscopic surgery does not increase the risk of recurrence and metastasis, and can accelerate postoperative recovery.