Liu Jie, Huang Bin-Jie, Ding Fei-Fei, Tang Fu-Tian, Li Yu-Min
Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China.
Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China.
World J Gastrointest Oncol. 2023 Oct 15;15(10):1807-1822. doi: 10.4251/wjgo.v15.i10.1807.
To evaluate the clinicopathological features and prognosis of gastric cancer (GC) occurring synchronously with gastrointestinal stromal tumor (GIST).
We report 19 patients with concurrent GC and GIST (17 male and 2 female, median age 62 years). GC was most often located in the lower third of the stomach. GIST was diagnosed preoperatively in four patients. GIST was most often located in the gastric body ( = 8, 42%). The most common growth pattern in GIST was extraluminal ( = 12, 63%). The positive expression rates of CD117 and CD34 in GIST were 100% and 95%, respectively. Most patients with GIST ( = 17, 89%) were very low or low risk. There was no recurrence of GIST during follow-up. The 3-year cumulative survival rate was 73.9%, and the 5-year cumulative survival rate was 59.2%. The combined analysis of this study and literature reports (47 reports, 157 patients) found that GC and GIST were usually located in the lower third (42%) and middle third (51%) of the stomach. GC was usually early (stage I: 42%), poorly differentiated (42%) intestinal-type adenocarcinoma (51%). GISTs were primarily small in diameter (median: 1.2 cm) and very low or low risk (89%).
Synchronous GC and GIST may not be rare. They have specific clinicopathological characteristics, and may have mutual inhibition in pathogenesis and progression.
评估与胃肠道间质瘤(GIST)同时发生的胃癌(GC)的临床病理特征及预后。
我们报告了19例同时患有GC和GIST的患者(男17例,女2例,中位年龄62岁)。GC最常位于胃的下三分之一处。4例患者术前诊断出GIST。GIST最常位于胃体部(8例,42%)。GIST最常见的生长方式为腔外生长(12例,63%)。GIST中CD117和CD34的阳性表达率分别为100%和95%。大多数GIST患者(17例,89%)为极低或低风险。随访期间GIST无复发。3年累积生存率为73.9%,5年累积生存率为59.2%。本研究与文献报道(47篇报道,157例患者)的综合分析发现,GC和GIST通常分别位于胃的下三分之一(42%)和中三分之一(51%)处。GC通常为早期(I期:42%)、低分化(42%)的肠型腺癌(51%)。GIST主要直径较小(中位值:1.2 cm)且为极低或低风险(89%)。
同时发生的GC和GIST可能并不罕见。它们具有特定的临床病理特征,并且在发病机制和进展过程中可能存在相互抑制作用。