Tryggvason Geir, Kristmundsson Thornórarinn, Orvar Kjartan, Jónasson Jón G, Magnússon Magnús K, Gíslason Hjörtur G
Department of Pathology, Landspitali University Hospital, Reykjavik, Iceland.
Dig Dis Sci. 2007 Sep;52(9):2249-53. doi: 10.1007/s10620-006-9248-4. Epub 2007 Apr 10.
This is a whole population-based study on clinical symptoms, surgical treatment, and outcome of GIST. All mesenchymal tumors in the digestive tract diagnosed from 1990 to 2003 were identified. All reports were reviewed, all tumors were stained with antibodies to c-kit, and the diagnosis of GIST was confirmed. Clinical, pathological, treatment, and outcome data were analyzed. The study included 53 patients with GIST. The mean age at diagnosis was 65.8+/-13.6 years (SD). Tumor distribution included 62% in the upper, 32% in the middle, and 6% in the lower digestive tract. Mean tumor size was 4.9+/-4.4 cm (SD). Gastrointestinal (GI) bleeding was the main symptom in 53% (20/38) of symptomatic cases; most presented with acute gastrointestinal bleeding. Complete surgical resection was performed in 87% (46/53) of patients. Eight of the 53 tumors (15.1%) metastasized, 7 of which were nongastric. The disease-specific death rate at 5 years was 85%, and 5-year survival after complete resection was 64.1%. We conclude that GISTs are often found incidentally but GI bleeding is the most common presentation. Five-year survival is better than previously reported and gastric GIST seems to be more benign than nongastric. GIST seems to metastasize mainly intra-abdominally.
这是一项基于全人群的关于胃肠道间质瘤（GIST）临床症状、手术治疗及预后的研究。我们识别了1990年至2003年期间诊断的所有消化道间叶组织肿瘤。对所有报告进行了回顾，所有肿瘤均用c-kit抗体染色，确诊为GIST。对临床、病理、治疗及预后数据进行了分析。该研究纳入了53例GIST患者。诊断时的平均年龄为65.8±13.6岁（标准差）。肿瘤分布情况为：上消化道62%，中消化道32%，下消化道6%。平均肿瘤大小为4.9±4.4厘米（标准差）。在有症状的病例中，53%（20/38）的主要症状为胃肠道（GI）出血；大多数表现为急性胃肠道出血。87%（46/53）的患者接受了完整的手术切除。53个肿瘤中有8个（15.1%）发生转移，其中7个为非胃来源。5年疾病特异性死亡率为85%，完整切除后的5年生存率为64.1%。我们得出结论，GIST常为偶然发现，但GI出血是最常见的表现形式。5年生存率优于先前报道，胃GIST似乎比非胃GIST更具良性。GIST似乎主要在腹腔内转移。
