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Clinicopathologic differences of mesenchymal submucosal tumors between the esophagogastric junction and the upper stomach

机译：食管胃交界处与上胃之间的间质黏膜下肿瘤的临床病理学差异

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Objective We compared the clinicopathologic features between mesenchymal tumors located in the esophagogastric junction (EGJ) and upper stomach, that had been removed surgically.Methods Thirty-five patients with a submucosal tumor (SMT) of the stomach, including the EGJ, were surgically treated over the last decade. Of these, 23 patients with SMTs located in the upper third of the stomach (n = 15; UG-group) and EGJ (n = 8; EGJ-group) were studied. Results The mean age was younger in the EGJ-group than in the UG-group, and the EGJ-group frequently showed symptoms. Histopathologically, 4 gastrointestinal stromal tumors (GISTs) and 4 leiomyomas were observed in the EGJ-group, while 14 GISTs and one schwannoma were observed in the UG-group (p = 0.0096). Two tumors macroscopically showed a horseshoe or spiral type in the EGJ-group, while all tumors showed a ball/ball-like appearance in the UG-group. Regarding surgical procedures, 7 patients underwent laparotomy in the EGJ-group, while 9 patients underwent laparoscopic surgery in the UG-group. The mean operating time was longer and operative bleeding was greater in the EGJ-group than in the UG-group, respectively (p = 0.0015 and p = 0.0095). Postoperative complications were frequently observed in the EGJ-group. The EGJ-group showed no patients with recurrence and/or metastasis after surgery, while three cases with GISTs had them in the UG-group. In GISTs, the mean mitotic index of the UG-group was relatively more than that of the EGJ-group and a case was classified into the high-risk group, although there was no significance in the risk classification between the two groups. Conclusion SMTs included GISTs and leiomyomas in the EGJ, while the majority demonstrated GISTs in the upper stomach. SMTs of the EGJ were removed by a tailored approach to prevent recurrence as well as postoperative complications. The biological behavior of GISTs may be different between the EJG and stomach.
机译：目的比较经手术切除的食管胃交界处（EGJ）和上胃之间的间质瘤的临床病理特征。方法对包括EGJ在内的35例胃黏膜下肿瘤（SMT）患者进行手术治疗。在过去十年中。在这些患者中，研究了23名SMT位于胃上三分之一的患者（n = 15; UG组）和EGJ（n = 8; EGJ组）。结果EGJ组的平均年龄比UG组年轻，并且EGJ组经常出现症状。在组织病理学上，在EGJ组中观察到4例胃肠道间质瘤（GIST）和4例平滑肌瘤，而在UG组中观察到14例GIST和1例神经鞘瘤（p = 0.0096）。宏观上，两个肿瘤在EGJ组中呈马蹄形或螺旋形，而在UG组中所有肿瘤均呈球形/球形。在外科手术方面，EGJ组有7例接受了剖腹手术，而UG组有9例接受了腹腔镜手术。与UG组相比，EGJ组的平均手术时间更长，手术出血更大（p = 0.0015和p = 0.0095）。 EGJ组经常观察到术后并发症。 EGJ组显示无术后复发和/或转移的患者，而UG组中有3例GIST患者。在GIST中，UG组的平均有丝分裂指数相对比EGJ组的平均有丝分裂指数更高，并且将病例分类为高风险组，尽管两组之间的风险分类没有意义。结论SMT包括EGJ中的GIST和平滑肌瘤，而大多数表现为上胃部GIST。通过量身定制的方法去除了EGJ的SMT，以防止复发以及术后并发症。 EJG和胃之间GIST的生物学行为可能有所不同。

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