Steigen Sonja Eriksson, Eide Tor J
Department of Pathology, University Hospital of Northern Norway, Tromsø, Norway.
APMIS. 2006 Mar;114(3):192-200. doi: 10.1111/j.1600-0463.2006.apm_261.x.
Population-based incidence and survival data for gastrointestinal stromal tumor (GIST) are sparse due to the fact that GIST is a rather novel entity both clinically and pathologically, and has not been registered as a separate entity in population-based cancer registries. The aim of the present study was to reclassify all mesenchymal tumors within a defined population of northern Norway over a time-span of 30 years with the purpose of estimating trends of incidence and survival. One hundred and forty-one patients with mesenchymal neoplasms of the digestive tract were identified: 102 as GISTs, 32 as leiomyomatous tumors, 4 as schwannomas, and 3 as fibromas. Incidence rates of GIST showed a significant increase over the whole period, which was not observed for the non-GIST cases. Analysis of GIST cases showed that cases with more than 5 mitoses per 50 high power fields had an increased expected mortality 4 times that of those with fewer mitoses, and the combination of mitotic count and size of tumor can be recommended for categorizing the tumors into different risk levels. The study confirms that GIST is by far the most frequent mesenchymal neoplasm of the digestive tract and that the incidence has increased over the last 30 years.
由于胃肠道间质瘤（GIST）在临床和病理上都是一种相当新的肿瘤实体，且在基于人群的癌症登记中未被登记为一个单独的实体，因此基于人群的GIST发病率和生存数据较为稀少。本研究的目的是对挪威北部特定人群在30年时间跨度内的所有间叶性肿瘤进行重新分类，以估计发病率和生存趋势。共确定了141例消化道间叶性肿瘤患者：102例为GIST，32例为平滑肌瘤性肿瘤，4例为神经鞘瘤，3例为纤维瘤。GIST的发病率在整个时期呈现显著上升，而非GIST病例则未观察到这种情况。对GIST病例的分析表明，每50个高倍视野中核分裂象超过5个的病例预期死亡率增加，是核分裂象较少病例的4倍，并且可以推荐将核分裂计数和肿瘤大小相结合来将肿瘤分为不同的风险级别。该研究证实，GIST是迄今为止消化道最常见的间叶性肿瘤，且在过去30年中发病率有所上升。
