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胰腺胃肠道间质瘤:临床病理特征与预后

Pancreatic Gastrointestinal Stromal Tumor: Clinicopathologic Features and Prognosis.

作者信息

Liu Zhen, Tian Yangzi, Xu Guanghui, Liu Shushang, Guo Man, Lian Xiao, Fan Daiming, Zhang Hongwei, Feng Fan

机构信息

*Division of Digestive Surgery, Xijing Hospital of Digestive Diseases †Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.

出版信息

J Clin Gastroenterol. 2017 Oct;51(9):850-856. doi: 10.1097/MCG.0000000000000719.

Abstract

GOALS

The present study aimed to investigate the clinicopathologic features and prognosis of pancreatic gastrointestinal stromal tumor (GIST).

BACKGROUND

Reports on clinicopathologic features and prognosis of pancreatic GIST are limited due to the extremely rare incidence.

STUDY

One case of pancreatic GIST from our center and 44 cases reported in MEDLINE were enrolled in this study. Clinicopathologic features and prognosis of pancreatic GISTs were analyzed and compared with 297 gastric GISTs from our center.

RESULTS

The most common location was head of pancreas (38.5%). The majority of pancreatic GISTs exceeded 5 cm (74.4%), displayed cystic or mixed imaging features (56.4%), and were high risk (85.7%). The 5-year disease-free survival (DFS) and disease-specific survival rates were 66.1% and 95.8%, respectively. Mitotic index was the only risk factor for DFS of pancreatic GISTs. The distribution of tumor size, histologic type and National Institutes of Health risk category were significantly different between pancreatic and gastric GISTs. The 5-year DFS rate of pancreatic GISTs was significantly lower than that of gastric GISTs. Multivariate analysis showed that location was an independent prognostic factor for DFS between pancreatic and gastric GISTs.

CONCLUSIONS

The most common location was head of pancreas. The majority of pancreatic GISTs were large and highly malignant. Pancreatic GISTs differed significantly from gastric GISTs in respect to clinicopathologic features. The DFS of pancreatic GISTs was worse than that of gastric GISTs.

摘要

目的

本研究旨在探讨胰腺胃肠道间质瘤(GIST)的临床病理特征及预后。

背景

由于胰腺GIST的发病率极低,关于其临床病理特征及预后的报道有限。

研究

本研究纳入了来自本中心的1例胰腺GIST病例以及MEDLINE上报道的44例病例。分析胰腺GIST的临床病理特征及预后,并与本中心的297例胃GIST进行比较。

结果

最常见的部位是胰头(38.5%)。大多数胰腺GIST直径超过5 cm(74.4%),表现为囊性或混合性影像学特征(56.4%),且为高风险(85.7%)。5年无病生存率(DFS)和疾病特异性生存率分别为66.1%和95.8%。有丝分裂指数是胰腺GIST DFS的唯一危险因素。胰腺GIST和胃GIST在肿瘤大小、组织学类型和美国国立卫生研究院风险分类的分布上存在显著差异。胰腺GIST的5年DFS率显著低于胃GIST。多因素分析显示,部位是胰腺GIST和胃GIST之间DFS的独立预后因素。

结论

最常见的部位是胰头。大多数胰腺GIST体积较大且恶性程度高。胰腺GIST在临床病理特征方面与胃GIST有显著差异。胰腺GIST的DFS比胃GIST更差。

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