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胃肠道转移的临床和内镜表现。

Clinical and endoscopic aspects of metastases to the gastrointestinal tract.

机构信息

Instituto do Câncer do Estado de São Paulo, São Paulo, Brasil.

出版信息

Endoscopy. 2019 Jul;51(7):646-652. doi: 10.1055/a-0887-4401. Epub 2019 May 14.

DOI:10.1055/a-0887-4401
PMID:31087306
Abstract

BACKGROUND

Studies that describe metastases to the gastrointestinal (GI) tract are restricted to small case series. An increase in the frequency of this condition is expected, so it would be useful to better characterize the endoscopic aspects of metastasis to the GI tract. The aims of this study were to describe the frequency and endoscopic features of the lesions, and to analyze the survival rate after diagnosis of metastasis.

METHODS

This was a retrospective, single-center, observational study, conducted between 2009 and 2017. Patients with metastasis to the GI tract were included.

RESULTS

95 patients were included. Melanoma (25.3 %), lung (15.8 %), and breast (14.7 %) were the most frequent primary tumors. The most common endoscopic presentation was a solitary, ulcerated lesion in the gastric body. Conventional biopsy was diagnostic in 98.9 % of the cases. The mean and median survival rates were 13.3 months (95 % confidence interval [CI] 8.2 - 18.3) and 4.7 months (95 %CI 3.7 - 5.6), respectively. Palliative treatment with chemo- and/or radiotherapy after the diagnosis of the metastasis was related to a higher survival rate.

CONCLUSIONS

Melanoma, lung, and breast cancer were the most common primary tumors to metastasize to the GI tract. The endoscopic features could not predict the primary site of the tumor. The finding of metastasis in the GI tract is related to the final stage of the cancer disease but patients who received palliative treatment with chemo- and/or radiotherapy after diagnosis of GI metastasis had higher survival rates.

摘要

背景

描述胃肠道(GI)转移的研究仅限于小病例系列。预计这种情况的频率会增加,因此更好地描述胃肠道转移的内镜特征将是有用的。本研究的目的是描述病变的频率和内镜特征,并分析诊断为转移后的生存率。

方法

这是一项回顾性、单中心、观察性研究,于 2009 年至 2017 年进行。纳入胃肠道转移的患者。

结果

共纳入 95 例患者。黑色素瘤(25.3%)、肺癌(15.8%)和乳腺癌(14.7%)是最常见的原发性肿瘤。最常见的内镜表现是胃体单发溃疡性病变。常规活检在 98.9%的病例中具有诊断意义。平均和中位生存率分别为 13.3 个月(95%置信区间 [CI] 8.2-18.3)和 4.7 个月(95%CI 3.7-5.6)。诊断为转移后接受化疗和/或放疗姑息治疗与更高的生存率相关。

结论

黑色素瘤、肺癌和乳腺癌是最常见的胃肠道转移的原发性肿瘤。内镜特征不能预测肿瘤的原发部位。在胃肠道中发现转移与癌症疾病的终末期有关,但在诊断为胃肠道转移后接受化疗和/或放疗姑息治疗的患者具有更高的生存率。

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