Wang Qipu, Li Muhan, Bai Xiaoyin, Zhang Ruishi, Ruan Suaizhi, Ou Chengzhu, Li Ji, Li Jingnan
Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, 1 Shuaifuyuan, Wangfujing, Beijing, 100730, China.
Guanghua School of Management, Peking University, Beijing, 100871, China.
BMC Gastroenterol. 2025 May 7;25(1):337. doi: 10.1186/s12876-025-03945-5.
Gastrointestinal stromal tumors (GISTs) are a rare and less well-characterized disease. There is limited information on the clinical features of small intestinal GISTs at different sites.
To enhance the understanding of the clinical characteristics and disease behavior of small intestinal GISTs based on their sites.
We conducted a retrospective review of medical records for 317 patients diagnosed with primary small intestinal GISTs confirmed by surgical pathology, comparing their clinical features and tumor characteristics.
According to this cohort's data, duodenal GISTs presented with longer disease durations and higher prevalence of melena (44.6%), while jejunal GISTs manifested as abdominal masses (11.5%) and acute gastrointestinal bleeding (GIB) (13.3%), with the highest rate of emergency surgeries (16.8%). Ileal GISTs were associated with an older age of onset and a higher prevalence of hematochezia (19.6%), with one-third of cases discovered incidentally during gynecological procedures. Notably, the biological behavior of small intestinal GISTs varied significantly by sites. Tumors demonstrated different immunochemical markers and a progressive increase in diameter, mitotic activity, T and M stages, and risk classification from the duodenum to the jejunum and ileum. These findings warrant further validation in prospective multicenter studies.
Small intestinal GISTs might exhibit distinct clinical presentations and oncological features depending on their sites.
胃肠道间质瘤（GISTs）是一种罕见且特征尚不明确的疾病。关于不同部位小肠GISTs的临床特征信息有限。
基于小肠GISTs的部位，增强对其临床特征和疾病行为的理解。
我们对317例经手术病理确诊为原发性小肠GISTs患者的病历进行了回顾性分析，比较了他们的临床特征和肿瘤特征。
根据该队列的数据，十二指肠GISTs病程较长，黑便发生率较高（44.6%），而空肠GISTs表现为腹部肿块（11.5%）和急性消化道出血（GIB）（13.3%），急诊手术率最高（16.8%）。回肠GISTs发病年龄较大，便血发生率较高（19.6%），三分之一的病例在妇科手术中偶然发现。值得注意的是，小肠GISTs的生物学行为因部位而异。肿瘤表现出不同的免疫化学标志物，从十二指肠到空肠和回肠，直径、有丝分裂活性、T和M分期以及风险分类逐渐增加。这些发现有待在前瞻性多中心研究中进一步验证。
小肠GISTs可能因其部位不同而表现出不同的临床表现和肿瘤学特征。
