Underreporting of Gastrointestinal Stromal Tumors: Is the True Incidence Being Captured?
Underreporting of Gastrointestinal Stromal Tumors: Is the True Incidence Being Captured?
复制标题
DOI：
10.1007/s11605-015-2860-x
复制
发表时间：
2015-09-01
影响因子：
3.2
通讯作者：
Kim, Joseph
中科院分区：
文献类型：
--
作者：
Choi, Audrey H.;Hamner, John B.;Kim, Joseph
医院癌症登记处只需要报告胃肠道间质瘤（gist），如果标记为恶性或转移，导致国家癌症登记处的病例潜在损失。我们的目的是确定gist在美国是否被低估了。在两个学术医疗中心对2010年至2013年诊断为GIST的病理报告进行回顾性审查。排除复发性gist。病理报告与每个癌症登记处报告的病例交叉参考。转移/死亡风险根据国家综合癌症网络（NCCN）指南确定。其中49例为非复发性GIST。49例中仅有19例（38.8%）报告。30例未报告的病例中没有一例在最终病理上被标记为恶性/转移。为了说明恶性肿瘤的可能性，我们对这些肿瘤进行了风险分层。大多数（60%）未报告的病例为低风险，但中、高、未知风险组各有4例（13.3%）。此外，7/30（23.0%）的病例使用酪氨酸激酶抑制剂治疗，突出了恶性GIST的临床关注。我们的研究结果表明，近三分之二的GIST病例被低估了，这表明目前的报告实践低估了其真实发病率。修订报告指南可能导致对美国GIST疾病负担的更准确估计。
Hospital cancer registries are only required to report gastrointestinal stromal tumors (GISTs) if labeled malignant or metastatic, leading to potential loss of cases in national cancer registries. Our objective was to determine whether GISTs are underreported in the US.Retrospective review of pathology reports between 2010 and 2013 with diagnosis of GIST was performed at two academic medical centers. Recurrent GISTs were excluded. Pathology reports were cross-referenced to cases reported by each cancer registry. Risk for metastasis/death was determined according to National Comprehensive Cancer Network (NCCN) guidelines.Forty-nine cases of non-recurrent GIST were identified. Only 19/49 (38.8 %) cases were reported. None of the 30 non-reported cases were labeled malignant/metastatic on final pathology. To illustrate malignant potential, these tumors were risk stratified. Most (60 %) of the non-reported cases were low risk, but there were 4 (13.3 %) cases each in the intermediate, high, and unknown risk groups. Additionally, 7/30 (23.0 %) cases were treated with tyrosine kinase inhibitors, highlighting clinical concern of malignant GIST.Our results show that nearly two thirds of GIST cases have been underreported, suggesting that current reporting practices underestimate its true incidence. Revision of reporting guidelines may result in a more accurate estimation of the US disease burden of GIST.