AIM To investigate whether laparoscopic surgery is as safe and feasible as open resection for patients with larger gastrointestinal stromal tumors(GISTs)(≥ 5 cm).METHODS A systematic search of Pub Med, EMBASE, Web of...AIM To investigate whether laparoscopic surgery is as safe and feasible as open resection for patients with larger gastrointestinal stromal tumors(GISTs)(≥ 5 cm).METHODS A systematic search of Pub Med, EMBASE, Web of Science and the Cochrane Library database was performed. Relevant studies of laparoscopic and open surgery for GISTs of > 5 cm published before December 2016 were identified from these databases. The quality of the studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. The tumor size, operation time, blood loss, postoperative hospital stay, complication rate, and disease-free survival rate were assessed. The software Stata(version 12.0) was used for the meta-analysis.RESULTS Five clinical trials comprising 209 patients with GISTs of similar larger sizes were evaluated. The pooled analysis of 100 patients in the laparoscopic resection group and 109 patients in the open resection group demonstrated that laparoscopic surgery was significantly associated with a shorter postoperative hospital stay(P < 0.001)and less blood loss(P = 0.002). Moreover, there were no statistically significant differences in the operation time(P = 0.38), postoperative complication rate(P = 0.88), or disease-free survival rate(P = 0.20) between two groups. CONCLUSION Our findings revealed that for patients with large GISTs of comparable sizes, laparoscopic surgery did not significantly influence the operation factors or clinical outcomes compared with open surgery. This suggests that laparoscopic resection is as acceptable as open surgery for treatment of large gastric GISTs.展开更多
Gastrointestinal stromal tumors(GISTs)are uncommon neoplasms of the gastrointestinal tract with peculiar clinical,genetic,and imaging characteristics.Preoperative knowledge of risk stratification and mutational status...Gastrointestinal stromal tumors(GISTs)are uncommon neoplasms of the gastrointestinal tract with peculiar clinical,genetic,and imaging characteristics.Preoperative knowledge of risk stratification and mutational status is crucial to guide the appropriate patients’treatment.Predicting the clinical behavior and biological aggressiveness of GISTs based on conventional computed tomography(CT)and magnetic resonance imaging(MRI)evaluation is challenging,unless the lesions have already metastasized at the time of diagnosis.Radiomics is emerging as a promising tool for the quantification of lesion heterogeneity on radiological images,extracting additional data that cannot be assessed by visual analysis.Radiomics applications have been explored for the differential diagnosis of GISTs from other gastrointestinal neoplasms,risk stratification and prediction of prognosis after surgical resection,and evaluation of mutational status in GISTs.The published researches on GISTs radiomics have obtained excellent performance of derived radiomics models on CT and MRI.However,lack of standardization and differences in study methodology challenge the application of radiomics in clinical practice.The purpose of this review is to describe the new advances of radiomics applied to CT and MRI for the evaluation of gastrointestinal stromal tumors,discuss the potential clinical applications that may impact patients’management,report limitations of current radiomics studies,and future directions.展开更多
目的探讨卵巢硬化性间质瘤(sclerosing stromaltumer of ovarg,SST)的临床病理、电镜及免疫组化特点。方法通过11例SST的临床、形态学特征、免疫组化及其中的5例电镜观察和10例随访。结果 11例中30岁以下8例,10例有月经紊乱,1例早熟,5...目的探讨卵巢硬化性间质瘤(sclerosing stromaltumer of ovarg,SST)的临床病理、电镜及免疫组化特点。方法通过11例SST的临床、形态学特征、免疫组化及其中的5例电镜观察和10例随访。结果 11例中30岁以下8例,10例有月经紊乱,1例早熟,5例伴有腹水。光镜显示假小叶结构及小叶间疏松水肿的结缔组织和致密的胶原纤维,瘤细胞形态多样,可见印戒样细胞,血管丰富。电镜见有三类瘤细胞:分别为类似储脂细胞,纤维母细胞及原始未分化间叶细胞,瘤细胞间或周围有大量的毛细血管。组织化学:PAS全部(-);免疫组化:α-inhibin7例(+),4例(-);ER4例(+),7例(-);CR3例(+),8例(-);vimentin、SMA、PR均(+);CK、EMA均(-)。随访:术后月经均恢复正常,已婚未育2例术后都怀孕生子,未婚者中术后有2例结婚并已生子。结论 SST是一种具有特殊组织学结构的少见卵巢良性肿瘤,术后不复发,预后好。病理诊断应注意与卵巢印戒细胞间质瘤、卵泡膜细胞瘤、卵巢纤维瘤、Krukenberg瘤等鉴别。展开更多
基金Supported by National Program on Key Basic Research Project of China,No.2014CBA02002National Key Research and Development Plan,No.2016YFC0905302+1 种基金National Natural Science Foundation of China,Nos.81672319 and 81602507Beijing Municipal Science and Technology Project,No.D131100005313010
文摘AIM To investigate whether laparoscopic surgery is as safe and feasible as open resection for patients with larger gastrointestinal stromal tumors(GISTs)(≥ 5 cm).METHODS A systematic search of Pub Med, EMBASE, Web of Science and the Cochrane Library database was performed. Relevant studies of laparoscopic and open surgery for GISTs of > 5 cm published before December 2016 were identified from these databases. The quality of the studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. The tumor size, operation time, blood loss, postoperative hospital stay, complication rate, and disease-free survival rate were assessed. The software Stata(version 12.0) was used for the meta-analysis.RESULTS Five clinical trials comprising 209 patients with GISTs of similar larger sizes were evaluated. The pooled analysis of 100 patients in the laparoscopic resection group and 109 patients in the open resection group demonstrated that laparoscopic surgery was significantly associated with a shorter postoperative hospital stay(P < 0.001)and less blood loss(P = 0.002). Moreover, there were no statistically significant differences in the operation time(P = 0.38), postoperative complication rate(P = 0.88), or disease-free survival rate(P = 0.20) between two groups. CONCLUSION Our findings revealed that for patients with large GISTs of comparable sizes, laparoscopic surgery did not significantly influence the operation factors or clinical outcomes compared with open surgery. This suggests that laparoscopic resection is as acceptable as open surgery for treatment of large gastric GISTs.
文摘Gastrointestinal stromal tumors(GISTs)are uncommon neoplasms of the gastrointestinal tract with peculiar clinical,genetic,and imaging characteristics.Preoperative knowledge of risk stratification and mutational status is crucial to guide the appropriate patients’treatment.Predicting the clinical behavior and biological aggressiveness of GISTs based on conventional computed tomography(CT)and magnetic resonance imaging(MRI)evaluation is challenging,unless the lesions have already metastasized at the time of diagnosis.Radiomics is emerging as a promising tool for the quantification of lesion heterogeneity on radiological images,extracting additional data that cannot be assessed by visual analysis.Radiomics applications have been explored for the differential diagnosis of GISTs from other gastrointestinal neoplasms,risk stratification and prediction of prognosis after surgical resection,and evaluation of mutational status in GISTs.The published researches on GISTs radiomics have obtained excellent performance of derived radiomics models on CT and MRI.However,lack of standardization and differences in study methodology challenge the application of radiomics in clinical practice.The purpose of this review is to describe the new advances of radiomics applied to CT and MRI for the evaluation of gastrointestinal stromal tumors,discuss the potential clinical applications that may impact patients’management,report limitations of current radiomics studies,and future directions.
