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CEBP:亚裔病人更易患胃肠道间质瘤

来源:生物谷 2014-10-11 15:49

2014年10月11日 讯 /生物谷BIOON/ --近日研究发现,加州大学圣地亚哥医学院的研究人员首次明确定义胃肠道间质肿瘤(GIST)的流行病学特征,这主要发生在胃和小肠内壁。一个关键的发现是亚裔病人比其他病人群体高出1.5倍的可能性被诊断为这种类型的肿瘤,而先前并没有确认亚裔病人是这种疾病的高危人群。该研究的结果发表在本周的《癌症流行病学》,《生物标记与预防》,《美国癌症研究协会杂志》等杂志上。

“之前的期刊文章从来没有明确区分GIST和其他肿瘤的区别,即使他们有不同的生物学现象,”Jason Sicklick博士说,“这项研究更清楚地鉴别出在美国的高危人群发病率,生存趋势和疾病的风险因素。”

在2001年之前,GIST特殊组织学代码不用于医疗编码,这意味着各种肿瘤的类型,如平滑肌瘤、平滑肌肉瘤、梭形细胞,肌纤维母细胞瘤,硬纤维瘤和KIT-阳性转移性黑素瘤都集中到一个类型中。Sicklick和他的团队用新一代病理诊断代码来定义不同的患者群体中GIST的发病率和分布情况。

研究小组发现每百万人口中总体发病率为6.8,这个发病率从2001年到2011年之间持续上升。在研究期间,诊断为GIST的病人平均年龄是64岁。GIST在男性中较为常见。

“与之前的报告相矛盾的是我们看到一个非常明显的生存差异,尤其是在非裔美国人病人血统中。”Sicklick说。非裔美国人或亚洲/太平洋诸岛原住民后裔可能有分别2.1和1.5倍的可能性比白种人更容易患GIST。

“在美国当高危人群进行诊断,预后和治疗时,我们需要进一步的研究为什么这些群体是高危人群。”James Murphy说。(生物谷Bioon.com)

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Epidemiology of Gastrointestinal Stromal Tumors in the Era of Histology Codes: Results of a Population-Based Study

Grace L. Ma1, James D. Murphy2, Maria E. Martinez3, and Jason K. Sicklick1,*

To date, all population-based epidemiologic data on gastrointestinal stromal tumor (GIST) in the United States predate the 2001 implementation of GIST-specific histology coding. As such, results from previous studies were limited due to inclusion of non-GIST abdominal or gastrointestinal sarcomas. We utilized a national cancer registry with modern day histological codes to gain greater insight into the true epidemiology of GIST in the United States. We identified 6,142 patients diagnosed with GIST between 2001 and 2011 in the Surveillance, Epidemiology, and End Results database. Incidence, survival, demographic risk factors, and prognostic factors were analyzed. Annual age-adjusted incidence rose from 0.55/100,000 in 2001 to 0.78/100,000 in 2011 and increased with age, peaking among 70-79 year olds (3.06/100,000). GIST was also more common in males than females [rate ratio (RR)=1.35], non-Hispanics than Hispanics (RR=1.23), and blacks (RR=2.07) or Asians/Pacific Islanders (RR=1.50) than whites. The study period had 5-year overall and GIST-specific survival rates of 65% and 79%, respectively. The 5-year overall survival rates for those with localized, regional, and metastatic disease at diagnosis were 77%, 64%, and 41%, respectively. Multivariate analyses demonstrated that older age at diagnosis, male sex, black race, and advanced stage at diagnosis were independent risk factors of worse overall survival. Multivariate analysis also showed the four aforementioned characteristics, along with earlier year of diagnosis, to be independent risk factors of worse GIST-specific survival. As the first population-based, epidemiological study of histologically confirmed disease, our findings provide a robust representation of GIST in the era of immunohistochemical diagnoses.

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