Analysis of pathological characteristics and prognosis for very low-and low-risk gastrointestinal stromal tumors
10.12354/j.issn.1000-8179.2024.20240633
- VernacularTitle:极低与低危险度胃肠间质瘤的病理及预后分析
- Author:
Liu SHASHA
1
;
Sun LIN
;
Li JIAXIN
;
Zhao SHUAI
;
Liu HUIMIN
;
Liang HAN
;
Sun YAN
Author Information
1. 天津医科大学肿瘤医院病理科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学中心,天津市消化系统肿瘤重点实验室(天津市 300060)
- Keywords:
gastrointestinal stromal tumor(GIST);
very low risk;
low risk;
prognosis;
monitoring
- From:
Chinese Journal of Clinical Oncology
2024;51(11):541-546
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the prognosis,clinicopathological characteristics,and genetic mutation features of patients with very low-and low-risk gastrointestinal stromal tumors(GISTs).Methods:A retrospective data collection of 433 patients with very low-and low-risk GISTs,diagnosed by pathology after surgical or endoscopic resection at Tianjin Medical University Cancer Institute&Hospital,was conduc-ted to analyze clinical pathology and prognosis.Results:Compared with low-risk GIST,a higher proportion of patients with very low-risk GIST had gastric GISTs,a Ki-67 index≤3%,and 0-1 mitotic indexes/5 mm2,whereas the proportion of patients with small intestinal GIST was low(all P<0.05).Genetic testing was performed in 118 patients,and there was no significant difference in the mutation types and KITmutation types between low-risk and very low-risk GISTs(all P>0.05).Patient follow-up was conducted on 87 very low-risk and 210 low-risk GIST pa-tients without other concurrent diseases,with a median follow-up of 86(27-158)months.None of the patients with very low-risk GISTs showed progression;three cases of low-risk GIST had recurrence or metastasis,with progression-free survival(PFS)ranging from 27 to 84 months.The mitotic indices of the primary tumors in these three patients were all 4/5 mm2,which is close to the critical value between the low-and intermediate-risk GIST mitotic indices,and all had KIT exon11 mutations.After the first progression,these three patients were treated with imatinib,and all survived until the end of follow-up,with overall survival ranging from 116 to 155 months.Conclusions:Among patients with low-risk GISTs,a very small number with high mitotic indices may have the potential for recurrence or metastasis,but after re-currence or metastasis,they can still maintain long-term,high-quality survival through targeted therapy,surgery,and other treatment meth-ods.The possibility of postoperative progression in very low-risk patients with GIST is extremely low,and the follow-up interval can be ap-propriately extended to reduce medical costs and alleviate the psychological burden on the patients and their families.
