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上消化道胃肠道间质瘤内镜治疗的疗效与安全性

Efficacy and Safety of Endoscopic Treatment for Gastrointestinal Stromal Tumors in the Upper Gastrointestinal Tract.

作者信息

Marcella Cicilia, Sarwar Shakeel, Ye Hui, Shi Rui Hua

机构信息

Department of Gastroenterology, Southeast University Affiliated Zhongda Hospital, Nanjing, China.

Department of Orthopedics, Southeast University Affiliated Zhongda Hospital, Nanjing, China.

出版信息

Clin Endosc. 2020 Jul;53(4):458-465. doi: 10.5946/ce.2019.121. Epub 2020 Mar 17.

Abstract

BACKGROUND/AIMS: Endoscopic treatment (ET) has been applied for decades to treat subepithelial tumors, including gastrointestinal stromal tumors (GISTs). However, the efficacy of ET remains debatable. In this study, we evaluated the efficacy and safety of ET for GISTs in the upper gastrointestinal tract.

METHODS

This retrospective single-center study included 97 patients who underwent ET. All patients were enrolled from July 2014 to July 2018. Parameters such as demographics, size, resection margin, complications, pathological features, procedure time, total cost, and follow-up were investigated and analyzed.

RESULTS

Our study achieved 100% en bloc resection and 77.4% (72/93) R0 resection. The most common location was the fundus with a mean tumor size of 2.1±1.43 cm. The mean age, procedure time, hospital stay, and cost were 59.7±11.29 years, 64.7±35.23 minutes, 6.8 days, and 5,337 dollars, respectively. According to National Institutes of Health classification, 63 (64.9%), 26 (26.8%), 5 (5.2%), and 3 (3.1%) patients belonged to the very low, low, intermediate, and high risk classification, respectively. Immunohistochemistry results showed a 100% positive rate of CD34, DOG-1, CD117, and Ki67. A mean follow-up of 21.3±13.0 months showed no recurrence or metastasis.

CONCLUSION

ET is effective and safe for curative removal of GISTs in the upper gastrointestinal tract, and it can be a treatment of choice for patients with no metastasis.

摘要

背景/目的:内镜治疗(ET)已应用数十年用于治疗包括胃肠道间质瘤(GIST)在内的上皮下肿瘤。然而,ET的疗效仍存在争议。在本研究中,我们评估了ET治疗上消化道GIST的疗效和安全性。

方法

这项回顾性单中心研究纳入了97例行ET的患者。所有患者均于2014年7月至2018年7月入组。对人口统计学、肿瘤大小、切除边缘、并发症、病理特征、手术时间、总费用和随访等参数进行了调查和分析。

结果

我们的研究实现了100%整块切除和77.4%(72/93)的R0切除。最常见的部位是胃底,平均肿瘤大小为2.1±1.43 cm。平均年龄、手术时间、住院时间和费用分别为59.7±11.29岁、64.7±35.23分钟、6.8天和5337美元。根据美国国立卫生研究院分类,分别有63例(64.9%)、26例(26.8%)、5例(5.2%)和3例(3.1%)患者属于极低、低、中、高风险分类。免疫组化结果显示CD34、DOG-1、CD117和Ki67的阳性率为100%。平均随访21.3±13.0个月未发现复发或转移。

结论

ET对于根治性切除上消化道GIST是有效且安全的,对于无转移的患者可作为一种治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c59/7403013/db17381eb235/ce-2019-121f1.jpg

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