臨床外科67巻11号

2012年10月発行

特集 外科医のための癌診療データ

臓器別最新データ 10．消化管間質腫瘍（GIST）

GISTの疫学

著者： 澤木明¹ 蟹江浩² 山田智則² 林克巳² 折戸悦朗² 山雄健次³

所属機関： ¹名古屋第二赤十字病院薬物療法科 ²名古屋第二赤十字病院消化器内科 ³愛知県がんセンター中央病院消化器内科部

ページ範囲：P.265 - P.269

文献概要

覚えておきたいデータ

◆頻度の高い初発症状は消化管出血，腹痛，腹部腫瘤であるが，GISTに特異的な症状はない．

◆GISTの発生頻度は100万人当たり10～15人で，原発部位は胃が最も多く，小腸，大腸と続き食道や腹膜はきわめて頻度が少ない．

◆大半のGISTは遺伝しないが，多発する場合や20歳以下の症例では遺伝性のGISTの可能性が高い．

参考文献

1）Goettsch WG, Bos SD, Breekveldt-Postma N, et al：Incidence of gastrointestinal stromal tumours is underestimated：Results of a nation-wide study. Eur J Cancer 41：2868-2872, 2005

2）Agaimy A, Wünsch PH：Sporadic Cajal cell hyperplasia is common in resection specimens for distal oesophageal carcinoma. A retrospective review of 77 consecutive surgical resection specimens. Virchows Arch 448：288-294, 2006

3）Agaimy A, Wünsch PH, Hofstaedter F, et al：Minute gastric sclerosing stromal tumors（GIST tumorlets）are common in adults and frequently show c-KIT mutations. Am J Surg Pathol 31：113-120, 2007

4）Nilsson B, Bümming P, Meis-Kindblom JM, et al：Gastrointesitinal stromal tumors：The incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era. Cancer 103：821-829, 2005

5）Kawanowa K, Sakuma Y, Sakurai S, et al：High incidence of microscopic gastrointestinal stromal tumors in the stomach. Hum Pathol 37：1527-1535, 2006

6）Agaimy A, Wünsch PH, Dirnhofer S, et al：Microscopic gastrointestinal stromal tumors in esophageal and intestinal surgical resection specimens：a clinicopathologic, immunohistochemical, and molecular study of 19 lesions. Am J Surg Pathol 32：867-873, 2008

7）Nishida T, Shirao K, Sawaki A, et al：Efficacy and safety profile of imatinib mesylate（ST1571）in Japanese patients with advanced gastrointestinal stromal tumors：a phase Ⅱ study（STI571B1202）. Int J Clin Oncol 13：244-251, 2008

8）Kanda T, Nishida T, Wada N, et al：Adjuvant therapy with imatinib mesylate after resection of primary high-risk gastrointestinal stromal tumors in Japanese patients. Int J Clin Oncol（inpress）.

9）Tryggvasib G, Gislason HG, Magnusson MK, et al：Gastrointestinal stromal tumors in Iceland, 1990-2003：The Icelandic GIST study, a population-based incidence and pathologic risk stratification study. Int J Cancer 117：289-293, 2005

10）Tran T, Davila JA, El-Serag HB：The epidemiology of malignant gastrointestinal stromal tumors：an analusis of 1458 cases from 1992 to 2000. Am J Gastroenterol 100：162-168, 2005

11）Miettinen M, Sobin LH, Lasota J：Gastrointestinal stromal tumors of the stomach：a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol 29：52-68, 2005

12）Kim KM, Kang DW, Moon WS, et al；Gastrointestinal Stromal Tumor Committee；Korean Gastrointestinal Pathology Study Group：Gastrointestinal stromal tumors in Koreans：it's incidence and the clinical, pathologic and immunohistochemical findings. J Korean Med Sci 20：977-984, 2005

13）Reddy P, Boci BA, Charbonneau C：The epidemilolgic, health-related quality of life, and economic burden of gastrointestinal stromal tumours. J Clin Pharm Ther 32：557-565, 2007

14）Kondblom LG, Meis-Kindblom J, Bumming P, et al：Incidence, prevalence, phenotype and biologic spectrum of gastrointestinal stromal cell tumors（GIST）-a population-based study of 600 cases. Ann Oncol 13（Suppl 5）：157, 2002

15）Cichoz-Lach H, Kasztelan-Szczerbińska B, Słomka M：Gastrointestinal stromal tumors：epidemiology, clinical picture, diagnosis, prognosis and treatment. Pol Arch Med Wewn 118：216-221, 2008

16）Goettsch WG, Bos SD, Breekveldt-Postma N, et al：Incidence of gastrointestinal stromal tumours is underestimated：results of a nation-wide study. Eur J Cancer 41：2868-2872, 2005

17）Conolly EM, Gaffney E, Reynolds JV：Gastrointestinal stromal tumors. Br J Surg 90：1178-1186, 2003

18）Nishida T, Hirota S, Taniguchi M, et al：Familial gastrointestinal stromal tumours with germline mutation of the KIT gene. Nat Genet 19：323-324, 1998

19）Yantiss RK, Rosenberg AE, Sarran L, et al：Multiple gastrointestinal stromal tumors in type Ⅰ neurofibromatosis：a pathologic and molecular study. Mod Pathol 18：475-484, 2005

20）Miettinen M, Majidi M, Lasota J：Pathology and diagnostic criteria of gastrointestinal stromal tumors（GISTs）：a review. Eur J Cancer 38（Suppl 5）：S39-51, 2002

21）de Raedt T, Cools J, Debiec-Rychter M, et al：Intestinal neurofibromatosis is a subtype of familial GIST and results from a dominant activating mutation in PDGFRA. Gastroenterology 131：1907-1912, 2006

22）Pasini B, McWhinney SR, Bei T, et al：Clinical and molecular genetics of patients with the Carney-Stratakis syndrome and germline mutations of the genes coding for the succinate dehydrogenase subunits SDHB, SDHC, and SDHD. Eur J Hum Genet 16：79-88, 2008

23）川口　実，三治哲哉，森安史典，他：GISTの臨床的対応．胃と腸36：1137-1145，2001

24）澤木　明，水野伸匡，伯耆徳之，他：GISTの自然史．胃と腸43：199-204，2008

25）Sawaki A, Mizuno N, Takahashi K, et al：Long-term follow up of patients with small Gastrointestinal stromal tumors in the stomach using endscopic ultrasonography-guided fine-needle aspiration biopsy. Digestive Endoscopy 18：40-44, 2006