Lakshmi Vasantha A, Chacko Raju T, Kurian Susy
Department of Pathology, Christian Medical College and Hospital, Ida Scudder Road, Vellore - 632 004, Tamil Nadu, India.
Indian J Pathol Microbiol. 2010 Oct-Dec;53(4):628-33. doi: 10.4103/0377-4929.72005.
Gastrointestinal stromal tumor (GIST), now the most common mesenchymal tumor of the gastrointestinal tract (GIT), has been frequently studied, especially with regard to its successful targeted therapy using imatinib mesylate.
Our aim was to describe the clinicopathological features of a large number of cases from a tertiary care hospital in India and report on the follow-up after treatment of some of the cases, comparing them with series described in the west.
This is a retrospective study of cases encountered over a 7-year period (1999-2005).
Ninety-two cases of GIST were studied, which made up the largest group (52.8%) of mesenchymal tumors of the GIT, with smooth muscle tumors comprising 38.1%, the next large group. GISTs were almost equally prevalent in the stomach and the small intestine, unlike in most studies where stomach is the most common site. GIST may be considered as a cause of bleeding when upper and lower GI endoscopy is normal. Ninety-five percent of the GISTs were positive for CD117 (KIT), as is known. A majority of them (70.4%) were of the high-risk malignant category, unlike most studies where high-risk tumors make up 30-45%. Histologically, the majority had a pure spindle cell morphology and skenoid fibers were rare. Follow-up of 11 cases, the majority with high-risk tumor, treated with adjuvant imatinib for 6 months after surgical resection showed stable disease for periods from 2 to 5 years. However, 11 cases treated with imatinib for longer than 6 months had a poorer outcome due to recurrent, metastatic, or inoperable disease.
In our study of a large number of GISTs, which were equally prevalent in the stomach and small intestine, the majority were of the high-risk malignant category and of pure spindle cell morphology. Limited numbers had follow-up after imatinib therapy, which showed in one group treated for 6 months, after resection of high-risk GIST, stable disease for periods ranging from 2 to 5 years. Molecular studies and larger numbers are required for meaningful conclusions to be drawn.
胃肠道间质瘤（GIST）是目前胃肠道最常见的间叶性肿瘤，已得到广泛研究，尤其是关于其使用甲磺酸伊马替尼的成功靶向治疗。
我们的目的是描述印度一家三级医疗医院大量病例的临床病理特征，并报告部分病例治疗后的随访情况，与西方报道的系列病例进行比较。
这是一项对7年期间（1999 - 2005年）所遇病例的回顾性研究。
研究了92例GIST病例，其构成胃肠道间叶性肿瘤的最大组（52.8%），平滑肌肿瘤占38.1%，为第二大组。与大多数研究中胃是最常见部位不同，GIST在胃和小肠中的发生率几乎相同。当上、下消化道内镜检查正常时，GIST可被视为出血原因。如所知，95%的GIST对CD117（KIT）呈阳性。其中大多数（70.4%）属于高危恶性类别，与大多数研究中高危肿瘤占30 - 45%不同。组织学上，大多数具有纯梭形细胞形态，且很少有席纹状纤维。对11例病例进行随访，大多数为高危肿瘤，手术切除后接受辅助性伊马替尼治疗6个月，病情稳定2至5年。然而，11例接受伊马替尼治疗超过6个月的病例，由于复发、转移或无法手术的疾病，预后较差。
在我们对大量GIST的研究中，其在胃和小肠中的发生率相同，大多数属于高危恶性类别且具有纯梭形细胞形态。伊马替尼治疗后的随访病例数量有限，其中一组高危GIST切除后接受6个月治疗，病情稳定2至5年。需要进行分子研究并纳入更多病例才能得出有意义的结论。
