AIM:To develop a prognostic approach for gastrointestinal stromal tumors(GISTs) using a cluster of indicators and follow-up information.METHODS:One hundred and four GISTs that had not been subjected to targeted therap...AIM:To develop a prognostic approach for gastrointestinal stromal tumors(GISTs) using a cluster of indicators and follow-up information.METHODS:One hundred and four GISTs that had not been subjected to targeted therapies were collected and classified by NIH risk assessment and anatomic location.By immunohistochemistry,the expressions of PTEN,Ki-67,CD44s matrix metalloproteinase(MMP)-9 and TIMP-1 were detected on tissue microarray.Univariate and multimarker survival analyses were performed and then a COX hazard proportion model was constructed to evaluate a cluster of predictors of GIST.RESULTS:Our data showed small intestinal GIST are more aggressive than gastric GIST.The NIH risk assessment correlated with disease-free survival foreither gastric GIST or small intestinal GIST.Immunohistochemical analysis revealed that Ki-67 labeling indexes(LIs) < 5% predicted higher disease-specific survival(DSS) in gastric and small intestinal GIST.CD44s positivity and PTEN LIs ≥ 50% correlated with higher DSS in gastric GIST.MMP-9 and TIMP-1 had no correlation with survival.Multimarker analysis revealed that the expression pattern of PTEN LIs ≥ 50% combined with Ki-67 LIs < 5% and CD44s positivity reliably predicted favorable outcomes for gastric GIST(P = 0.009),as did the combination of PTEN LIs ≥ 50% and Ki-67 LIs < 5% for small intestinal GIST(P = 0.011).Authors also found that high NIH risk grade was correlated with DSS in patients with gastric GIST and disease-free survival in patients with small intestinal GIST.CONCLUSION:PTEN LIs ≥ 50%,Ki-67 LIs < 5% and CD44s positivity provides an accurate,favorable prognosis for gastric GIST.PTEN LIs ≥ 50% and Ki-67 LIs < 5% does the same for small intestinal GIST.Ki-67 LIs enhances the NIH assessment.展开更多
The complex gut microbial flora harbored by individuals(microbiota) has long been proposed to contribute tointestinal health as well as disease. Pre-and probioticproducts aimed at improving health by modifyingmicrobio...The complex gut microbial flora harbored by individuals(microbiota) has long been proposed to contribute tointestinal health as well as disease. Pre-and probioticproducts aimed at improving health by modifyingmicrobiota composition have already become widelyavailable and acceptance of these products appearsto be on the rise. However, although required forthe development of effective microbiota basedinterventions, our basic understanding of microbiotavariation on a population level and its dynamics withinindividuals is still rudimentary. Powerful new parallelsequence technologies combined with other efficientmolecular microbiota analysis methods now allow forcomprehensive analysis of microbiota composition inlarge human populations. Recent fi ndings in the fi eldstrongly suggest that microbiota contributes to thedevelopment of obesity, atopic diseases, inflammatorybowel diseases and intestinal cancers. Through theongoing National Institutes of Health Roadmap 'HumanMicrobiome Project' and similar projects in other partsof the world, a large coordinated effort is currentlyunderway to study how microbiota can impact humanhealth. Translating findings from these studies intoeffective interventions that can improve health,possibly personalized based on an individuals existingmicrobiota, will be the task for the next decade(s).展开更多
OBJECTIVE To analyze the pathological features and prognosis factors of gastrointestinal stromal tumor （GIST） after primary resection. METHODS Medical records of the diagnosis, surgery, and follow-up of 327 patients...OBJECTIVE To analyze the pathological features and prognosis factors of gastrointestinal stromal tumor （GIST） after primary resection. METHODS Medical records of the diagnosis, surgery, and follow-up of 327 patients with GISTs who underwent surgery between 1988 and 2007 were retrospectively reviewed. The predic-tive factors for the survival of these patients were identi. ed using multivariate analysis. RESULTS In the 327 tumors, 152 （46.5%） were located in the stomach, 89 （27.2%） in the small intestine, 33 （10.1%） in the colon and rectum, and 43 （13.1%） in other sites including the omentum and mesentery. The 3-year and 5-year overall survival rates of the 327 GIST patients were 74.4% and 62.7%, respectively, and univariate survival analysis demonstrated that factors, such as tumor size, mitotic index, NIH categories, Ki-67 index, tumor location, surgical margins, tumor bleeding, and tumor necrosis have significant effect on survival of the patients （P 〈 0.05）. Multivariate analysis demonstrated that the NIH categories, surgical margins, and Ki-67 index were independent prognostic factors for the survival rate. In the group of patients with postoperative recurrence or metastasis, the median survival time of patients who did not receive imatinib treatment was 30 months and that of patients who received imatinib treatment was 59 months. Their 5-year survival rates were 16.4% and 39.4%, respectively, and the difference was statistically significant （P = 0.017）. CONCLUSION Complete resection is the .rst choice of treat-ment for GISTs. It is reasonable to evaluate the prognosis of resect-able GISTs and guide the adjunctive therapy with NIH categories and Ki-67 index. Imatinib treatment can signi.cantly increase the survival rate of patients with recurrent and metastatic GISTs.展开更多
基金Supported by Grants from the National Key Basic Research Program Project of China,No.2004CB518708National BioTech 863 program,No. 2002-BA711 A11
文摘AIM:To develop a prognostic approach for gastrointestinal stromal tumors(GISTs) using a cluster of indicators and follow-up information.METHODS:One hundred and four GISTs that had not been subjected to targeted therapies were collected and classified by NIH risk assessment and anatomic location.By immunohistochemistry,the expressions of PTEN,Ki-67,CD44s matrix metalloproteinase(MMP)-9 and TIMP-1 were detected on tissue microarray.Univariate and multimarker survival analyses were performed and then a COX hazard proportion model was constructed to evaluate a cluster of predictors of GIST.RESULTS:Our data showed small intestinal GIST are more aggressive than gastric GIST.The NIH risk assessment correlated with disease-free survival foreither gastric GIST or small intestinal GIST.Immunohistochemical analysis revealed that Ki-67 labeling indexes(LIs) < 5% predicted higher disease-specific survival(DSS) in gastric and small intestinal GIST.CD44s positivity and PTEN LIs ≥ 50% correlated with higher DSS in gastric GIST.MMP-9 and TIMP-1 had no correlation with survival.Multimarker analysis revealed that the expression pattern of PTEN LIs ≥ 50% combined with Ki-67 LIs < 5% and CD44s positivity reliably predicted favorable outcomes for gastric GIST(P = 0.009),as did the combination of PTEN LIs ≥ 50% and Ki-67 LIs < 5% for small intestinal GIST(P = 0.011).Authors also found that high NIH risk grade was correlated with DSS in patients with gastric GIST and disease-free survival in patients with small intestinal GIST.CONCLUSION:PTEN LIs ≥ 50%,Ki-67 LIs < 5% and CD44s positivity provides an accurate,favorable prognosis for gastric GIST.PTEN LIs ≥ 50% and Ki-67 LIs < 5% does the same for small intestinal GIST.Ki-67 LIs enhances the NIH assessment.
文摘The complex gut microbial flora harbored by individuals(microbiota) has long been proposed to contribute tointestinal health as well as disease. Pre-and probioticproducts aimed at improving health by modifyingmicrobiota composition have already become widelyavailable and acceptance of these products appearsto be on the rise. However, although required forthe development of effective microbiota basedinterventions, our basic understanding of microbiotavariation on a population level and its dynamics withinindividuals is still rudimentary. Powerful new parallelsequence technologies combined with other efficientmolecular microbiota analysis methods now allow forcomprehensive analysis of microbiota composition inlarge human populations. Recent fi ndings in the fi eldstrongly suggest that microbiota contributes to thedevelopment of obesity, atopic diseases, inflammatorybowel diseases and intestinal cancers. Through theongoing National Institutes of Health Roadmap 'HumanMicrobiome Project' and similar projects in other partsof the world, a large coordinated effort is currentlyunderway to study how microbiota can impact humanhealth. Translating findings from these studies intoeffective interventions that can improve health,possibly personalized based on an individuals existingmicrobiota, will be the task for the next decade(s).
文摘OBJECTIVE To analyze the pathological features and prognosis factors of gastrointestinal stromal tumor （GIST） after primary resection. METHODS Medical records of the diagnosis, surgery, and follow-up of 327 patients with GISTs who underwent surgery between 1988 and 2007 were retrospectively reviewed. The predic-tive factors for the survival of these patients were identi. ed using multivariate analysis. RESULTS In the 327 tumors, 152 （46.5%） were located in the stomach, 89 （27.2%） in the small intestine, 33 （10.1%） in the colon and rectum, and 43 （13.1%） in other sites including the omentum and mesentery. The 3-year and 5-year overall survival rates of the 327 GIST patients were 74.4% and 62.7%, respectively, and univariate survival analysis demonstrated that factors, such as tumor size, mitotic index, NIH categories, Ki-67 index, tumor location, surgical margins, tumor bleeding, and tumor necrosis have significant effect on survival of the patients （P 〈 0.05）. Multivariate analysis demonstrated that the NIH categories, surgical margins, and Ki-67 index were independent prognostic factors for the survival rate. In the group of patients with postoperative recurrence or metastasis, the median survival time of patients who did not receive imatinib treatment was 30 months and that of patients who received imatinib treatment was 59 months. Their 5-year survival rates were 16.4% and 39.4%, respectively, and the difference was statistically significant （P = 0.017）. CONCLUSION Complete resection is the .rst choice of treat-ment for GISTs. It is reasonable to evaluate the prognosis of resect-able GISTs and guide the adjunctive therapy with NIH categories and Ki-67 index. Imatinib treatment can signi.cantly increase the survival rate of patients with recurrent and metastatic GISTs.
