Yan Lin-Hai, Chen Zhi-Ning, Li Chun-Jun, Chen Jia, Qin Yu-Zhou, Chen Jian-Si, Tang Wei-Zhong
Department of Gastrointestinal Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Department of Pathology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
J Cancer. 2018 Oct 5;9(21):3850-3857. doi: 10.7150/jca.25263. eCollection 2018.
Imatinib has been regarded as the first successful synthetic small molecule targeting at blocking tyrosine kinase. Its high efficacy stabilized disease in above 80% of chronic myeloid leukemia (CML) patients over 10 years survival. Due to the similar canceration of gastrointestinal stromal tumor (GIST) as to CML, imatinib has been approved to be used as first-line treatment. Our retrospective study was proposed to enroll 191 GIST patients with larger tumor size (≥8 cm) who preoperative accepted imatinib from those with direct operation. Analysis included demographics, cancer specific survival and relationship of their risk factors. Male patients and gastrointestinal (GI) tract location took higher proportion in total cases, detection of KIT mutant took 89.7% among all traceable genetic testing. Patients with preoperative imatinib can achieve higher cancer specific survival (CSS) after both in 1 year and 3 years duration than their counterpart. Tumor size above its threshold of 8 cm would be a hazardous factor for poor prognosis. In conclusion, as for regressing tumor progression and creating operative chance, preoperative imatinib should be considered for the patients with high risk, although the precise duration of this intervention needs further validation.
伊马替尼被视为首个成功的靶向阻断酪氨酸激酶的合成小分子。其高效性使超过80%的慢性髓性白血病（CML）患者在长达10年的生存期内病情稳定。由于胃肠道间质瘤（GIST）与CML的致癌机制相似，伊马替尼已被批准用作一线治疗药物。我们的回顾性研究纳入了191例肿瘤体积较大（≥8 cm）且术前接受伊马替尼治疗的GIST患者，并将其与直接接受手术的患者进行对比分析。分析内容包括人口统计学特征、癌症特异性生存率及其危险因素之间的关系。男性患者和胃肠道（GI）部位在所有病例中占比更高，在所有可检测的基因检测中，KIT突变的检出率为89.7%。术前接受伊马替尼治疗的患者在术后1年和3年的癌症特异性生存率（CSS）均高于未接受该治疗的患者。肿瘤大小超过8 cm的阈值将是预后不良的危险因素。总之，对于高风险患者，为了使肿瘤进展消退并创造手术机会，应考虑术前使用伊马替尼，尽管这种干预的确切持续时间需要进一步验证。
