在伊马替尼时代的空肠回肠胃肠道间质瘤（GISTs）的特征和预后：与胃 GISTs 的对比研究。

Characteristics and prognosis of jejunoileal gastrointestinal stromal tumours (GISTs) in the era of imatinib: a comparative study with gastric GISTs.

机构信息

Digestive Surgery Department, Sarcoma Unit, "Virgen de La Arrixaca" University Hospital, Crta. Madrid Cartagena S/N, 30500, Murcia, Spain.

Pathology Department, "Virgen de La Arrixaca" University Hospital, Murcia, Spain.

出版信息

Clin Transl Oncol. 2021 Jul;23(7):1368-1376. doi: 10.1007/s12094-020-02528-y. Epub 2021 Jan 30.

DOI:10.1007/s12094-020-02528-y

PMID:33515420

Abstract

BACKGROUND

Gastrointestinal stromal tumours (GISTs) located in the jejunum or ileum (JI-GIST) are considered worse prognosis compared to those of gastric (G-GIST) location. It has been suggested that this dogma should be revised. The aim of this study was to describe the characteristics of jejunoileal GISTs and its prognosis and to compare them with G-GISTs in the era of imatinib.

METHODS

We retrospectively reviewed the clinical histories of all the patients diagnosed with GISTs between January 2000 and November 2016: Clinical and pathological data, as recurrence, metastatic state, disease-free survival (DFS) as well as overall survival (OS) rates of patients were reviewed.

RESULTS

JI-GIST patients comprise 29 cases (37.7%). Compared to G-GIST, JI-GIST patients had undergone emergency surgery more frequently (37.9% vs. 10.4%, p = 0.007). According to the NIH-Fletcher classification, the low or very-low risk group represents 17.2% of JI-GISTs as opposed to 37.6% of G-GISTs (p < 0.005). When the AFIP-Miettinen system was used the low or very-low group represented 17.2% of JI-GISTs vs. 58.4% in the G-GISTs group (p < 0.001). Both local recurrence (24.1% vs. 12.5%, p < 0.05) and metastatic rate (34.5% vs. 22.9%, p < 0.05) were higher in the JI-GIST group than in G-GIST. 5- and 10-year DFS and 10-year OS rate were lower for JI-GIST (54.5% and 39.6% vs. 77.2% and 60.8%, and 57.9% vs. 65%, respectively, p < 0.05).

CONCLUSIONS

The observed differences between both groups in DFS and OS rates at long term could be attributed to the effect of imatinib.

摘要

背景

与胃（G-GIST）位置相比，位于空肠或回肠（JI-GIST）的胃肠道间质瘤（GIST）被认为预后更差。有人认为这种观点应该被修正。本研究的目的是描述空肠回肠 GIST 的特征及其预后，并将其与伊马替尼时代的 G-GIST 进行比较。

方法

我们回顾性分析了 2000 年 1 月至 2016 年 11 月期间所有诊断为 GIST 的患者的临床病史：回顾患者的复发、转移状态、无病生存（DFS）和总生存（OS）率等临床和病理数据。

结果

JI-GIST 患者 29 例（37.7%）。与 G-GIST 相比，JI-GIST 患者更常接受急诊手术（37.9% vs. 10.4%，p=0.007）。根据 NIH-Fletcher 分类，低或极低风险组占 JI-GIST 的 17.2%，而 G-GIST 为 37.6%（p<0.005）。当使用 AFIP-Miettinen 系统时，低或极低组占 JI-GIST 的 17.2%，而 G-GIST 为 58.4%（p<0.001）。JI-GIST 组的局部复发率（24.1% vs. 12.5%，p<0.05）和转移率（34.5% vs. 22.9%，p<0.05）均高于 G-GIST 组。JI-GIST 的 5 年和 10 年 DFS 和 10 年 OS 率均较低（54.5%和 39.6% vs. 77.2%和 60.8%，和 57.9% vs. 65%，p<0.05）。