Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg 86156, Germany.
Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg 86156, Germany.
World J Gastroenterol. 2019 Aug 14;25(30):4261-4277. doi: 10.3748/wjg.v25.i30.4261.
In recent years, increasing evidence of second neoplasms associated with gastrointestinal stromal tumors (GIST) has been found. Numerous case reports, mostly retrospective studies and a few reviews, have been published. To our knowledge, however, no systematic review or meta-analysis of the existing data has been performed so far.
To prepare a compilation, as complete as possible, of all reported second tumor entities that have been described in association with GIST and to systematically analyze the published studies with regard to frequency, localization, and types of GIST-associated neoplasms.
The MEDLINE and EBSCO databases were searched for a combination of the keywords GIST/secondary, synchronous, coincident/tumor, neoplasm, and relevant publications were selected by two independent authors.
Initially, 3042 publications were found. After deletion of duplicates, 1631 remained, and 130 papers were selected; 22 of these were original studies with a minimum of 20 patients, and 108 were case reports. In the 22 selected studies, comprising a total number of 12050 patients, an overall rate of GIST-associated neoplasias of 20% could be calculated. Most second neoplasias were found in the gastrointestinal tract (32%) and in the male and female urogenital tract (30%). The specific risk scores of GISTs associated with other tumors were significantly lower than those without associated neoplasias.
In this first systematic review, we could confirm previously reported findings of a more than coincidental association between GIST and other neoplasias. The question whether there is an underlying causal association will need further investigation. Our data suggest that even GIST with a very low risk of disease progression should prompt screening for second neoplasia and subsequent frequent controls or extended staging.
近年来，越来越多的证据表明胃肠道间质瘤（GIST）与第二肿瘤相关。已发表了大量病例报告，主要是回顾性研究，还有少数综述。然而，据我们所知，目前尚未对现有数据进行系统的回顾或荟萃分析。
尽可能完整地收集与 GIST 相关的所有已报道的第二肿瘤实体，并系统地分析已发表的研究，以评估 GIST 相关肿瘤的频率、定位和类型。
通过 MEDLINE 和 EBSCO 数据库搜索关键词 GIST/继发性、同步、巧合/肿瘤、新生物，并由两位独立作者选择相关出版物。
最初发现了 3042 篇文献。删除重复项后，剩余 1631 篇，选择了 130 篇论文；其中 22 篇为至少有 20 例患者的原始研究，108 篇为病例报告。在 22 项选定的研究中，共纳入了 12050 例患者，总体 GIST 相关肿瘤的发生率为 20%。大多数第二肿瘤发生在胃肠道（32%）和男性和女性泌尿生殖道（30%）。与其他肿瘤相关的 GIST 的特定风险评分明显低于无相关肿瘤的 GIST。
在这项首次系统评价中，我们可以证实之前报道的 GIST 与其他肿瘤之间存在巧合之外的关联。是否存在潜在的因果关联还需要进一步研究。我们的数据表明，即使是疾病进展风险非常低的 GIST，也应提示筛查第二肿瘤，并随后进行频繁的检查或扩展分期。
