Refai Fahd
Department of Pathology, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, SAU.
Cureus. 2024 Jul 15;16(7):e64560. doi: 10.7759/cureus.64560. eCollection 2024 Jul.
Gastrointestinal stromal tumors (GISTs) are a significant subset of mesenchymal tumors primarily found in the gastrointestinal tract, impacting diagnostic and therapeutic approaches. Understanding their epidemiology is crucial for improving patient care and advancing treatment strategies.
Our study at a Saudi tertiary hospital analyzed 50 patients with GIST, focusing on demographics, tumor locations, and risk assessments. We examined predictors of tumor size, including mitosis frequency, and assessed the impact of anatomical location and risk on clinical outcomes using RStudio software (Posit, Boston, MA).
Among 50 patients with GIST, 36 (72.0%) were male with a median age of 60.5 years, and most tumors (33, 66.0%) were in the stomach. Risk assessments categorized tumors as follows: 20 (40.0%) low risk, 12 (24.0%) high risk, 7 (14.0%) moderate risk, 7 (14.0%) very low risk, and 4 (8.0%) no risk. Most tumors were low-grade (41, 82.0%) and nonmetastatic (47, 94.0%), predominantly spindle cell type (37, 74.0%). Tumor size varied significantly across risk categories: high-risk tumors averaged 10.3 cm versus 0.5 cm for no risk and 3.5 cm for very low risk ( < 0.001). Mitosis frequency differed significantly by risk category and tumor grade ( < 0.001). Tumor grade varied notably with risk categories and morphologic types, especially high-grade tumors in high-risk groups (8, 66.7%) and epithelioid tumors (2, 100%). Multivariable analysis identified predictors of tumor size: anatomical location (extra-GI, intra-abdominal; beta = 7.08, = 0.011) and risk assessment (low risk, beta = 6.91, = 0.001; moderate risk, beta = 11.2, < 0.001; high risk, beta = 8.93, < 0.001). Liver metastasis did not differ significantly across gender, anatomical location, risk assessment, or tumor grade.
In Saudi Arabia, GISTs predominantly affect males and are primarily located in the stomach. Our findings highlight significant variations in tumor size and grade based on risk assessments and anatomical location. Most GISTs were low-grade, nonmetastatic, and spindle cell type, emphasizing the need for enhanced research to improve diagnostics, tailor treatments, and optimize outcomes in the region.
胃肠道间质瘤（GISTs）是间充质肿瘤的一个重要子集，主要见于胃肠道，影响诊断和治疗方法。了解其流行病学对于改善患者护理和推进治疗策略至关重要。
我们在沙特一家三级医院开展的研究分析了50例GIST患者，重点关注人口统计学、肿瘤位置和风险评估。我们研究了肿瘤大小的预测因素，包括有丝分裂频率，并使用RStudio软件（Posit，马萨诸塞州波士顿）评估了解剖位置和风险对临床结局的影响。
在50例GIST患者中，36例（72.0%）为男性，中位年龄为60.5岁，大多数肿瘤（33例，66.0%）位于胃。风险评估将肿瘤分类如下：20例（40.0%）低风险，12例（24.0%）高风险，7例（14.0%）中度风险，7例（14.0%）极低风险，4例（8.0%）无风险。大多数肿瘤为低级别（41例，82.0%）且无转移（47例，94.0%），主要为梭形细胞类型（37例，74.0%）。肿瘤大小在不同风险类别中差异显著：高风险肿瘤平均为10.3 cm，无风险肿瘤为0.5 cm，极低风险肿瘤为3.5 cm（<0.001）。有丝分裂频率在不同风险类别和肿瘤级别中差异显著（<0.001）。肿瘤级别随风险类别和形态学类型显著变化，尤其是高风险组中的高级别肿瘤（8例，66.7%）和上皮样肿瘤（2例，100%）。多变量分析确定了肿瘤大小的预测因素：解剖位置（胃肠道外、腹腔内；β=7.08，P=0.011）和风险评估（低风险，β=6.91，P=0.001；中度风险，β=11.2，P<0.001；高风险，β=8.93，P<0.001）。肝转移在性别、解剖位置、风险评估或肿瘤级别方面无显著差异。
在沙特阿拉伯，GISTs主要影响男性，且主要位于胃。我们的研究结果突出了基于风险评估和解剖位置的肿瘤大小和级别的显著差异。大多数GISTs为低级别、无转移且为梭形细胞类型，强调需要加强研究以改善该地区的诊断、定制治疗方案并优化治疗结局。
