1.Factors related to efficacy in HIVAIDS patients co-infected with Talaromyces marneffei and antibiotic susceptibility testing of isolated strains
WANG Yandaijiu ; GAO Li ; LI Zhenglun
China Tropical Medicine 2025;25(1):117-
Objective To analyze the in vitro yeast-phase drug susceptibility testing of 82 Talaromyces marneffei (TM) strains isolated at Yunnan Infectious Disease Hospital and their association with patient therapeutic outcomes. The study aims to investigate the antifungal resistance breakpoint for TM through in vitro susceptibility tests, evaluate the stability of the susceptibility testing methods, and assess the correlation between in vitro susceptibility test results and different clinical outcomes in HIV/AIDS patients with TM. This research provides a theoretical basis for the clinical selection of highly effective and low-toxicity antifungal drugs in treating HIV/AIDS with TM infection and aims to improve the clinical treatment quality. Methods Clinical data from 82 HIV/AIDS patients co-infected with TM from 2017 to 2021 were retrospectively collected. The minimum inhibitory concentration (MIC) of TM strains from these patients was tested using the microdilution method at Yunnan Provincial Infectious Disease Hospital. Patients were divided into two groups based on therapeutic outcomes: good and poor. Statistical analyses were performed on epidemiological data, clinical characteristics, laboratory data, and treatment regimens between the two groups. Correlations between different MIC results and therapeutic outcomes were analyzed, and independent risk factors affecting prognosis were identified using multivariate logistic regression. The predictive value of the diagnostic indicators was assessed using the Receiver Operating Characteristic (ROC) curves. Results Clinical efficacy: Out of the 82 patients, 38 had good outcomes and 44 had poor outcomes. Univariate analysis showed statistically significant differences (P<0.05) in abnormal imaging features, CD4+T lymphocyte count, duration of antifungal therapy, white blood cell (WBC) count, total protein (TP), albumin (ALB), and use of itraconazole. Patients who received itraconazole had better outcomes, with statistically significant differences (P<0.05). In vitro susceptibility testing: MICs for 82 TM strains were <4 to 4 mg/L for 5-fluorocytosine, <0.5 to 0.5 mg/L for amphotericin B, <1 to 8 mg/L for fluconazole, <0.125 mg/L for itraconazole, and <0.06 to 0.06 mg/L for voriconazole. There were no statistical differences in efficacy among patients with different susceptibility results for the same drug. Prognostic model: A significantly reduced CD4+T cell count was an independent risk factor for poor TM treatment outcomes, with a ROC curve area under the curve (AUC) of 0.983 (95%CI: 0.963-1.000), specificity of 0.955, and sensitivity of 0.919. Conclusion The tested TM strains showed good sensitivity to all five antifungal drugs. Sequential treatment with itraconazole can improve patient prognosis, and CD4+T cell count is an independent risk factor affecting the prognosis of patients with TM infection.
2.The Influence of Double-Headed Screws on Stability of Multi-Rod Structures in Posterior Three-Column Spinal Osteotomy
Yunqian LIAO ; Yu ZHOU ; Zhenglun WANG ; Yongsheng LIU ; Wei LI
Journal of Medical Biomechanics 2024;39(3):407-412
Objective To compare the stability of multi-rod structures with double-headed screws and traditional connectors in posterior three-column osteotomy of the spine using finite element analysis.Methods A finite element model of the T3-L4 thoracolumbar spine was constructed based on postoperative computed tomography(CT)data of patients with severe kyphosis.Based on the patient's standard two-rod model(2R),a double-headed screw multi-rod structure model(4R-DHS)and a traditional connector multi-rod structure model(4R-TC)were constructed.The two models were evaluated under 300 N follower load and 7.5 N-m moment load,and the stability,maximum von Mises stresses on the main rods,and stress distributions of the two multi-rod structures were analyzed.Results There was little difference in the stability between the two multi-rod structures.Compared with 4R-TC,4R-DHS showed a decrease in the maximum von Mises stresses on the main rods during all motions(the stress decreased by 7.2%,8.8%,8.7%,18.5%,and 16.9%during flexion,left lateral bending,right lateral bending,left axial rotation,and right axial rotation,respectively)and more uniform stress distribution,except for a slight increase in the maximum von Mises stresses on the main rods during post-extension.Conclusions The double-headed screw multi-rod structure can reduce the maximum stress on the main rod compared with the traditional connector multi-rod structure,and there is no problem with stress concentration on the main rod near the connector,which can more effectively reduce the risk of internal fixation failure.
3.Laparoscopic diagnosis of postoperative recurrence of peritoneal metastasis in gastric cancer patients and the clinical efficacy of bidirectional intraperitoneal and systemic chemotherapy
Chao YAN ; Zhongyin YANG ; Min SHI ; Wei XU ; Zhentian NI ; Zichen HUA ; Wentao LIU ; Zhenglun ZHU ; Renda BI ; Yanan ZHENG ; Runhua FENG ; Xuexin YAO ; Mingmin CHEN ; Chen LI ; Jun ZHANG ; Min YAN ; Zhenggang ZHU
Chinese Journal of Gastrointestinal Surgery 2020;23(5):492-498
Objective:To explore the diagnostic value of laparoscopy in the postoperative recurrence of peritoneal metastasis in gastric cancer, and to investigate the efficacy of bidirectional intraperitoneal and systemic (BIPS) chemotherapy for the recurrence.Methods:The descriptive case series study was conducted. Case inclusion criteria: (1) gastric cancer patients without synchronous distant metastasis received D2 radical gastrectomy; (2) postoperative adjuvant chemotherapy was administered; (3) no other distant metastasis except recurrence of peritoneal metastasis; (4) age of 18-75 years; (5) Eastern Cooperative Oncology Group (ECOG) performance-status score≤2; (6) pretreatment evaluation suggested that surgery and chemotherapy could be tolerated. Eight consecutive gastric cancer patients with postoperative recurrence of peritoneal metastasis who met the above criteria at Department of Gastrointestinal Surgery of Ruijin Hospital from September 2015 to September 2016 were enrolled into the study. There were 6 males and 2 females with the median age of 52 (38-68) years. They received laparoscopy or laparotomy first, and then were evaluated with reference to the Sugarbaker peritoneal cancer index (PCI) and the peritoneal metastasis classification of gastric cancer developed by the Japanese Gastric Cancer Research Association. A peritoneal access port was implanted in the subcutaneous space of the lower abdomen and the patients received chemotherapy for 21 days as a course of treatment. All the patients received intraperitoneal 20 mg/m 2 of paclitaxel (PTX) via implanted subcutaneous peritoneal access ports and intravenous 50 mg/m 2 of PTX at day 1 and day 8, meanwhile 80 mg/m 2 of Tigio was orally administered per day for 14 consecutive days, followed by 7 days of interval. Follow-up ended on December 15, 2019. Results:Of these 8 patients with recurrence of peritoneal metastasis after gastric cancer surgery, 1 case underwent laparotomy and loop stoma of terminal ileum because of complete colonic obstruction, and the remaining 7 cases underwent laparoscopy successfully and the recurrence of peritoneal metastasis was clearly diagnosed. Two patients with ovarian metastasis underwent laparoscopic bilateral adnexectomy. The median follow-up time was 17.5 (1.5 to 39.0) months, the median number of BIPS chemotherapy course was 11 (1 to 30), and the median survival time (MST) after BIPS chemotherapy was 17.0 months. The major adverse reaction in BIPS treatment was mainly myelosuppression, of which grade 3/4 leukopenia and neutropenia developed in 1 and 2 cases respectively. No BIPS-related death occurred. The MST of gastric cancer after radical gastrectomy was 40.0 months.Conclusions:Laparoscopy is a safe and feasible method for diagnosing the recurrence of peritoneal metastasis of gastric cancer. BIPS chemotherapy is effective and safe for its treatment and deserves further study.
4.Laparoscopic diagnosis of postoperative recurrence of peritoneal metastasis in gastric cancer patients and the clinical efficacy of bidirectional intraperitoneal and systemic chemotherapy
Chao YAN ; Zhongyin YANG ; Min SHI ; Wei XU ; Zhentian NI ; Zichen HUA ; Wentao LIU ; Zhenglun ZHU ; Renda BI ; Yanan ZHENG ; Runhua FENG ; Xuexin YAO ; Mingmin CHEN ; Chen LI ; Jun ZHANG ; Min YAN ; Zhenggang ZHU
Chinese Journal of Gastrointestinal Surgery 2020;23(5):492-498
Objective:To explore the diagnostic value of laparoscopy in the postoperative recurrence of peritoneal metastasis in gastric cancer, and to investigate the efficacy of bidirectional intraperitoneal and systemic (BIPS) chemotherapy for the recurrence.Methods:The descriptive case series study was conducted. Case inclusion criteria: (1) gastric cancer patients without synchronous distant metastasis received D2 radical gastrectomy; (2) postoperative adjuvant chemotherapy was administered; (3) no other distant metastasis except recurrence of peritoneal metastasis; (4) age of 18-75 years; (5) Eastern Cooperative Oncology Group (ECOG) performance-status score≤2; (6) pretreatment evaluation suggested that surgery and chemotherapy could be tolerated. Eight consecutive gastric cancer patients with postoperative recurrence of peritoneal metastasis who met the above criteria at Department of Gastrointestinal Surgery of Ruijin Hospital from September 2015 to September 2016 were enrolled into the study. There were 6 males and 2 females with the median age of 52 (38-68) years. They received laparoscopy or laparotomy first, and then were evaluated with reference to the Sugarbaker peritoneal cancer index (PCI) and the peritoneal metastasis classification of gastric cancer developed by the Japanese Gastric Cancer Research Association. A peritoneal access port was implanted in the subcutaneous space of the lower abdomen and the patients received chemotherapy for 21 days as a course of treatment. All the patients received intraperitoneal 20 mg/m 2 of paclitaxel (PTX) via implanted subcutaneous peritoneal access ports and intravenous 50 mg/m 2 of PTX at day 1 and day 8, meanwhile 80 mg/m 2 of Tigio was orally administered per day for 14 consecutive days, followed by 7 days of interval. Follow-up ended on December 15, 2019. Results:Of these 8 patients with recurrence of peritoneal metastasis after gastric cancer surgery, 1 case underwent laparotomy and loop stoma of terminal ileum because of complete colonic obstruction, and the remaining 7 cases underwent laparoscopy successfully and the recurrence of peritoneal metastasis was clearly diagnosed. Two patients with ovarian metastasis underwent laparoscopic bilateral adnexectomy. The median follow-up time was 17.5 (1.5 to 39.0) months, the median number of BIPS chemotherapy course was 11 (1 to 30), and the median survival time (MST) after BIPS chemotherapy was 17.0 months. The major adverse reaction in BIPS treatment was mainly myelosuppression, of which grade 3/4 leukopenia and neutropenia developed in 1 and 2 cases respectively. No BIPS-related death occurred. The MST of gastric cancer after radical gastrectomy was 40.0 months.Conclusions:Laparoscopy is a safe and feasible method for diagnosing the recurrence of peritoneal metastasis of gastric cancer. BIPS chemotherapy is effective and safe for its treatment and deserves further study.
5. Analysis and comparison of the clinical features and prognosis between extra - gastrointestinal stromal tumors and duodenal gastrointestinal stromal tumors
Hongpeng SHI ; Zhenqiang WANG ; Zhiyuan FAN ; Mingde ZANG ; Jiaomeng PAN ; Qingqiang DAI ; Yanan ZHENG ; Zhenglun ZHU ; BirendraKumar SAH ; Wentao LIU ; Zhongyin YANG ; Runhua FENG ; Xuexin YAO ; Mingmin CHEN ; Chao YAN ; Min YAN ; Zhenggang ZHU ; Chen LI
Chinese Journal of Gastrointestinal Surgery 2019;22(9):856-860
Objective:
To investigate the differences of clinicopathological features, diagnosis, treatment and prognosis between patients with extra-gastrointestinal stromal tumors (EGIST) and duodenal gastrointestinal stromal tumors (DGIST).
Methods:
A retrospective case - control study was performed. Case inclusion criteria: (1) tumor confirmed by histology and pathology; (2) primary tumor locating in the extra - gastrointestinal tract or duodenum; (3) without other synchronous tumors; (4) complete clinical and pathological data. Clinical data of 20 EGIST patients and 32 DGIST patients from March 2011 to September 2016 at Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were retrospectively collected and analyzed. The observational parameters included clinicopathological characteristics, treatment and prognosis conditions. Continuous data of abnormal distribution were expressed as median (range) and compared using the Mann-Whitney
6. Predictive factors for lymph node metastasis in patients with poorly differentiated early gastric cancer
Boran PANG ; Zhenglun ZHU ; Chen LI ; Wentao LIU ; Birendra KUMARSAH ; Min YAN ; Zhenggang ZHU
Chinese Journal of Gastrointestinal Surgery 2019;22(5):446-450
Objective:
This study aimed to identify clinicopathological factors predictive of lymph node metastasis in patients with the poorly differentiated early gastric cancer (EGC) to assess the feasibility of using endoscopic submucosal dissection (ESD).
Methods:
The records of patients with poorly differentiated early gastric cancer undergoing gastric radical resection between January 2012 and December 2016 were reviewed in Ruijin hospital. Those with distant metastasis, two or more malignant tumors, remnant gastric cancer, neo adjuvant therapy, previous history of gastric surgery or clear history of perigastric lymphadenectomy, and mixed tumors were excluded. Age, sex, presence of ulcerous lesion, tumor size, tumor location, depth of invasion, type of differentiation, lymphatic vessel invasion, vascular invasion, nerve invasion and HER2 expression were collected. Univariate and multivariate stepwise logistic regression analyses were used to identify the independent risk factors of perigastric lymph node metastasis.According to the Guidelines for the Treatment of Gastric Cancer (2018 edition) of the Chinese Society of Clinical Oncology (CSCO), the expanded indications of ESD for EGC are as follows: (1)no ulcerative lesions, the maximum diameter of lesions >2 cm of differentiated intramucosal cancer; (2)ulcerative lesions, the maximum diameter of lesions ≤3 cm of differentiated intramucosal cancer; (3)no ulcerative lesions, undifferentiated intramucosal carcinoma with diameter ≤2 cm. The relationship between clinicopathological factors and lymph node metastasis was analyzed.
Results:
A total of 517 patients, aged 21-83 (57.1±11.7), including 307 males and 210 females, were enrolled in the study. Among them, 114 (22.0%) patients had lymph node metastasis. Univariate analysis showed that ulcerative lesion (
7.Predictive factors for lymph node metastasis in patients with poorly differentiated early gastric cancer
Boran PANG ; Zhenglun ZHU ; Chen LI ; Wentao LIU ; Sah Kumar BIRENDRA ; Min YAN ; Zhenggang ZHU
Chinese Journal of Gastrointestinal Surgery 2019;22(5):446-450
Objective This study aimed to identify clinicopathological factors predictive of lymph node metastasis in patients with the poorly differentiated early gastric cancer (EGC) to assess the feasibility of using endoscopic submucosal dissection (ESD). Methods The records of patients with poorly differentiated early gastric cancer undergoing gastric radical resection between January 2012 and December 2016 were reviewed in Ruijin hospital. Those with distant metastasis, two or more malignant tumors, remnant gastric cancer, neo adjuvant therapy, previous history of gastric surgery or clear history of perigastric lymphadenectomy, and mixed tumors were excluded. Age, sex, presence of ulcerous lesion, tumor size, tumor location, depth of invasion, type of differentiation, lymphatic vessel invasion, vascular invasion, nerve invasion and HER2 expression were collected. Univariate and multivariate stepwise logistic regression analyses were used to identify the independent risk factors of perigastric lymph node metastasis.According to the Guidelines for the Treatment of Gastric Cancer (2018 edition) of the Chinese Society of Clinical Oncology (CSCO), the expanded indications of ESD for EGC are as follows: (1)no ulcerative lesions, the maximum diameter of lesions >2 cm of differentiated intramucosal cancer; (2) ulcerative lesions, the maximum diameter of lesions ≤3 cm of differentiated intramucosal cancer; (3)no ulcerative lesions, undifferentiated intramucosal carcinoma with diameter≤2 cm. The relationship between clinicopathological factors and lymph node metastasis was analyzed. Results A total of 517 patients, aged 21?83 (57.1±11.7), including 307 males and 210 females, were enrolled in the study. Among them, 114 (22.0%) patients had lymph node metastasis. Univariate analysis showed that ulcerative lesion (P=0.042), tumor diameter (P=0.048), depth of invasion (P<0.001), location of tumors (P<0.001), lymphatic vessel invasion (P=0.009), vascular invasion (P<0.001) and nerve invasion (P=0.028) were related to lymph node metastasis after radical resection of poorly differentiated early adenocarcinoma. Age, sex, type of differentiation and HER2 expression were not significantly correlated to lymph node metastasis (P>0.05). Multivariate analysis showed that tumor size (OR=1.61, 95% CI: 1.03?2.52, P=0.037), depth of invasion (OR=2.77, 95% CI:1.66?4.63, P<0.001), lymphatic duct invasion (OR=14.74, 95% CI: 1.58?137.36, P=0.018) were independent risk factors for lymph node metastasis in poorly differentiated EGC, and ulcerative lesion was not a risk factor for lymph node metastasis (OR=0.82, 95% CI:0.56?1.18,P=0.285). A total of 119 patients with poorly differentiated EGC fully complied with the relative indications of ESD recommended by the Japanese Statute and the criteria for radical resection after ESD. Among them, 14 (11.8%) still had perigastric lymph node metastasis, while the gender, tumor diameter, location, differentiation and HER2 expression were not associated with lymph node metastasis (P>0.05). Conclusion For patients with poorly differentiated EGC, the application of ESD should be carefully weighed with precise assessment of tumor diameter, depth of invasion, and lymphatic duct invasion.
8.Analysis and comparison of the clinical features and prognosis between extra? gastrointestinal stromal tumors and duodenal gastrointestinal stromal tumors
Hongpeng SHI ; Zhenqiang WANG ; Zhiyuan FAN ; Mingde ZANG ; Jiaomeng PAN ; Qingqiang DAI ; Yanan ZHENG ; Zhenglun ZHU ; BirendraKumar SAH ; Wentao LIU ; Zhongyin YANG ; Runhua FENG ; Xuexin YAO ; Mingmin CHEN ; Chao YAN ; Min YAN ; Zhenggang ZHU ; Chen LI
Chinese Journal of Gastrointestinal Surgery 2019;22(9):856-860
Objective To investigate the differences of clinicopathological features, diagnosis, treatment and prognosis between patients with extra?gastrointestinal stromal tumors (EGIST) and duodenal gastrointestinal stromal tumors (DGIST). Methods A retrospective case?control study was performed. Case inclusion criteria: (1) tumor confirmed by histology and pathology; (2) primary tumor locating in the extra?gastrointestinal tract or duodenum; (3) without other synchronous tumors; (4) complete clinical and pathological data. Clinical data of 20 EGIST patients and 32 DGIST patients from March 2011 to September 2016 at Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were retrospectively collected and analyzed. The observational parameters included clinicopathological characteristics, treatment and prognosis conditions. Continuous data of abnormal distribution were expressed as median (range) and compared using the Mann?Whitney U?test. Survival curves were drawn by the Kaplan?Meier method and compared with the Log?rank test. Results Of the 20 EGIST patients, 8 were males and 12 were females with age of 61.0 (30.0 to 86.0) years and of the 32 DGIST patients, 12 were males and 20 were females with age of 55.5 (27.0 to 70.0) years. Compared with DGIST patients, EGIST patients were older (U=188.000, P=0.012], had larger tumor size [10.0 (3.0 to 29.0) cm vs. 4.0 (1.5 to 10.0) cm, U=98.500, P<0.001] and higher ratio of high risk classification [85.0% (17/20) vs. 12.5% (4/32), χ2=26.870, P<0.001]. Among the 20 EGIST patients, 5 were diagnosed with distal metastasis and received imatinib (400 mg/d), and the other 15 patients underwent radical resection who were included in survival analysis. All the 32 DGIST patients underwent radical resection. The median follow?up of whole group was 43 (14 to 76) months. The 3?year recurrence/metastasis?free survival rate of 15 cases undergoing radical resection in the EGIST group was 85.6%, which was lower than that of the DGIST group (88.6%), and the difference was not statistically significant (P=0.745). There was no significant difference in the 3?year overall survival rate between the EGIST group (92.9%) and the DGIST group (100%) (P=0.271). Conclusions As compared to DGIST, EGIST mostly occurs in those with older age, larger tumor size and higher risk grade. The prognosis of EGIST patients after radical resection is similar to that of DGIST patients.
9.Predictive factors for lymph node metastasis in patients with poorly differentiated early gastric cancer
Boran PANG ; Zhenglun ZHU ; Chen LI ; Wentao LIU ; Sah Kumar BIRENDRA ; Min YAN ; Zhenggang ZHU
Chinese Journal of Gastrointestinal Surgery 2019;22(5):446-450
Objective This study aimed to identify clinicopathological factors predictive of lymph node metastasis in patients with the poorly differentiated early gastric cancer (EGC) to assess the feasibility of using endoscopic submucosal dissection (ESD). Methods The records of patients with poorly differentiated early gastric cancer undergoing gastric radical resection between January 2012 and December 2016 were reviewed in Ruijin hospital. Those with distant metastasis, two or more malignant tumors, remnant gastric cancer, neo adjuvant therapy, previous history of gastric surgery or clear history of perigastric lymphadenectomy, and mixed tumors were excluded. Age, sex, presence of ulcerous lesion, tumor size, tumor location, depth of invasion, type of differentiation, lymphatic vessel invasion, vascular invasion, nerve invasion and HER2 expression were collected. Univariate and multivariate stepwise logistic regression analyses were used to identify the independent risk factors of perigastric lymph node metastasis.According to the Guidelines for the Treatment of Gastric Cancer (2018 edition) of the Chinese Society of Clinical Oncology (CSCO), the expanded indications of ESD for EGC are as follows: (1)no ulcerative lesions, the maximum diameter of lesions >2 cm of differentiated intramucosal cancer; (2) ulcerative lesions, the maximum diameter of lesions ≤3 cm of differentiated intramucosal cancer; (3)no ulcerative lesions, undifferentiated intramucosal carcinoma with diameter≤2 cm. The relationship between clinicopathological factors and lymph node metastasis was analyzed. Results A total of 517 patients, aged 21?83 (57.1±11.7), including 307 males and 210 females, were enrolled in the study. Among them, 114 (22.0%) patients had lymph node metastasis. Univariate analysis showed that ulcerative lesion (P=0.042), tumor diameter (P=0.048), depth of invasion (P<0.001), location of tumors (P<0.001), lymphatic vessel invasion (P=0.009), vascular invasion (P<0.001) and nerve invasion (P=0.028) were related to lymph node metastasis after radical resection of poorly differentiated early adenocarcinoma. Age, sex, type of differentiation and HER2 expression were not significantly correlated to lymph node metastasis (P>0.05). Multivariate analysis showed that tumor size (OR=1.61, 95% CI: 1.03?2.52, P=0.037), depth of invasion (OR=2.77, 95% CI:1.66?4.63, P<0.001), lymphatic duct invasion (OR=14.74, 95% CI: 1.58?137.36, P=0.018) were independent risk factors for lymph node metastasis in poorly differentiated EGC, and ulcerative lesion was not a risk factor for lymph node metastasis (OR=0.82, 95% CI:0.56?1.18,P=0.285). A total of 119 patients with poorly differentiated EGC fully complied with the relative indications of ESD recommended by the Japanese Statute and the criteria for radical resection after ESD. Among them, 14 (11.8%) still had perigastric lymph node metastasis, while the gender, tumor diameter, location, differentiation and HER2 expression were not associated with lymph node metastasis (P>0.05). Conclusion For patients with poorly differentiated EGC, the application of ESD should be carefully weighed with precise assessment of tumor diameter, depth of invasion, and lymphatic duct invasion.
10.Analysis and comparison of the clinical features and prognosis between extra? gastrointestinal stromal tumors and duodenal gastrointestinal stromal tumors
Hongpeng SHI ; Zhenqiang WANG ; Zhiyuan FAN ; Mingde ZANG ; Jiaomeng PAN ; Qingqiang DAI ; Yanan ZHENG ; Zhenglun ZHU ; BirendraKumar SAH ; Wentao LIU ; Zhongyin YANG ; Runhua FENG ; Xuexin YAO ; Mingmin CHEN ; Chao YAN ; Min YAN ; Zhenggang ZHU ; Chen LI
Chinese Journal of Gastrointestinal Surgery 2019;22(9):856-860
Objective To investigate the differences of clinicopathological features, diagnosis, treatment and prognosis between patients with extra?gastrointestinal stromal tumors (EGIST) and duodenal gastrointestinal stromal tumors (DGIST). Methods A retrospective case?control study was performed. Case inclusion criteria: (1) tumor confirmed by histology and pathology; (2) primary tumor locating in the extra?gastrointestinal tract or duodenum; (3) without other synchronous tumors; (4) complete clinical and pathological data. Clinical data of 20 EGIST patients and 32 DGIST patients from March 2011 to September 2016 at Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were retrospectively collected and analyzed. The observational parameters included clinicopathological characteristics, treatment and prognosis conditions. Continuous data of abnormal distribution were expressed as median (range) and compared using the Mann?Whitney U?test. Survival curves were drawn by the Kaplan?Meier method and compared with the Log?rank test. Results Of the 20 EGIST patients, 8 were males and 12 were females with age of 61.0 (30.0 to 86.0) years and of the 32 DGIST patients, 12 were males and 20 were females with age of 55.5 (27.0 to 70.0) years. Compared with DGIST patients, EGIST patients were older (U=188.000, P=0.012], had larger tumor size [10.0 (3.0 to 29.0) cm vs. 4.0 (1.5 to 10.0) cm, U=98.500, P<0.001] and higher ratio of high risk classification [85.0% (17/20) vs. 12.5% (4/32), χ2=26.870, P<0.001]. Among the 20 EGIST patients, 5 were diagnosed with distal metastasis and received imatinib (400 mg/d), and the other 15 patients underwent radical resection who were included in survival analysis. All the 32 DGIST patients underwent radical resection. The median follow?up of whole group was 43 (14 to 76) months. The 3?year recurrence/metastasis?free survival rate of 15 cases undergoing radical resection in the EGIST group was 85.6%, which was lower than that of the DGIST group (88.6%), and the difference was not statistically significant (P=0.745). There was no significant difference in the 3?year overall survival rate between the EGIST group (92.9%) and the DGIST group (100%) (P=0.271). Conclusions As compared to DGIST, EGIST mostly occurs in those with older age, larger tumor size and higher risk grade. The prognosis of EGIST patients after radical resection is similar to that of DGIST patients.

Result Analysis
Print
Save
E-mail