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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/20523完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 王秀伯(Hsiu-Po Wang) | |
| dc.contributor.author | Shenq-Jie Wong | en |
| dc.contributor.author | 黃聖潔 | zh_TW |
| dc.date.accessioned | 2021-06-08T02:51:46Z | - |
| dc.date.copyright | 2017-09-13 | |
| dc.date.issued | 2017 | |
| dc.date.submitted | 2017-08-14 | |
| dc.identifier.citation | Agaimy A, Wünsch PH, Hofstaedter F, Blaszyk H, Rümmele P, Gaumann A, Dietmaier W, Hartmann A. Minute gastric sclerosing stromal tumors (GIST tumorlets) are common in adults and frequently show c-KIT mutations. Am J Surg Pathol. 2007;31(1):113-20.
Binmoeller KF, Shah JN, Bhat YM, Kane SD. Retract-ligate-unroof-biopsy: a novel approach to the diagnosis and therapy of large nonpedunculated stromal tumors (with video). Gastrointest Endosc 2013; 77:803. Binmoeller KF, Shah JN, Bhat YM, Kane SD. Suck-ligate-unroof-biopsy by using a detachable 20-mm loop for the diagnosis and therapy of small subepithelial tumors (with video). Gastrointest Endosc. 2014 May;79(5):750-5. Cantor MJ, Davila RE, Faigel DO. Yield of tissue sampling for subepithelial lesions evaluated by EUS: a comparison between forceps biopsies and endoscopic submucosal resection. Gastrointest Endosc. 2006;64(1):29-34. Coe TM, Fero KE, Fanta PT, Mallory RJ, Tang CM, Murphy JD, Sicklick JK. Population-Based Epidemiology and Mortality of Small Malignant Gastrointestinal Stromal Tumors in the USA. J Gastrointest Surg. 2016 Jun;20(6):1132-40. Corless CL, McGreevey L, Haley A, Town A, Heinrich MC. KIT mutations are common in incidental gastrointestinal stromal tumors one centimeter or less in size. Am J Pathol 2002; 160: 1567–72. de la Serna-Higuera C, Pérez-Miranda M, Díez-Redondo P, et al. EUS-guided single-incision needle-knife biopsy: description and results of a new method for tissue sampling of subepithelial GI tumors. Gastrointest Endosc. 2011 Sep;74(3):672-6. Fang YJ, Cheng TY, Sun MS, Yang CS, Chen JH, Liao WC, Wang HP. Suggested cutoff tumor size for management of small EUS-suspected gastric gastrointestinal stromal tumors. J Formos Med Assoc. 2012;111(2):88-93. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol. 2002 May;33(5):459-65. Forde PM, Cochran RL, Boikos SA, Zabransky DJ, Beaver JA, Meyer CF, Thornton KA, Montgomery EA, Lidor AO, Donehower RC, Park BH. Familial GI Stromal Tumor With Loss of Heterozygosity and Amplification of Mutant KIT. J Clin Oncol. 2016 Jan 20;34(3):e13-6. doi: 10.1200/JCO.2013.51.6633. Epub 2014 May 27. Gao Z, Wang C, Xue Q, et al. The cut-off value of tumor size and appropriate timing of follow-up for management of minimal EUS-suspected gastric gastrointestinal stromal tumors. BMC Gastroenterology. 2017;17:8. Gomes AL, Bardales RH, Milanezi F, Reis RM, Schmitt F. Molecular analysis of c-Kit and PDGFRA in GISTs diagnosed by EUS. Am J Clin Pathol. 2007 Jan;127(1):89-96. Hoda KM, Rodriguez SA, Faigel DO. EUS-guided sampling of suspected GI stromal tumors. Gastrointest Endosc. 2009;69(7):1218-23. Hwang JH, Kimmey MB. The incidental upper gastrointestinal subepithelial mass. Gastroenterology. 2004;126(1):301-7. Ihara E, Matsuzaka H, Honda K, Hata Y, Sumida Y, Akiho H, Misawa T, Toyoshima S, Chijiiwa Y, Nakamura K, Takayanagi R. Mucosal-incision assisted biopsy for suspected gastric gastrointestinal stromal tumors. World J Gastrointest Endosc 2013; 5: 191-196. Joensuu H, Fletcher C, Dimitrijevic S, et al. Management of malignant gastrointestinal stromal tumours. Lancet Oncol 2002;3:655-64. Jones DH, Caracciolo JT, Hodul PJ, Strosberg JR, Coppola D, Bui MM. Familial gastrointestinal stromal tumor syndrome: report of 2 cases with KIT exon 11 mutation. Cancer Control. 2015;22:102–8. Karaca C, Turner BG, Cizginer S, Forcione D, Brugge W. Accuracy of EUS in the evaluation of small gastric subepithelial lesions. Gastrointest Endosc. 2010;71(4):722-7 Kataoka M, Kawai T, Yagi K, Sugimoto H, et al. Mucosal cutting biopsy technique for histological diagnosis of suspected gastrointestinal stromal tumors of the stomach. Dig Endosc. 2013 May;25(3):274-80. Kawanowa K, Sakuma Y, Sakurai S, Hishima T, Iwasaki Y, Saito K, Hosoya Y, Nakajima T, Funata N. High incidence of microscopic gastrointestinal stromal tumors in the stomach. Hum Pathol. 2006 Dec;37(12):1527-35. Kim JH, Chung J-W, Ha M, et al. A feasible modified biopsy method for tissue diagnosis of gastric subepithelial tumors. World Journal of Gastroenterology : WJG. 2013;19(29):4752-4757. Kleinbaum EP, Lazar AJ, Tamborini E, McAuliffe JC, Sylvestre PB, Sunnenberg TD, et al. Clinical, histopathologic, molecular and therapeutic findings in a large kindred with gastrointestinal stromal tumor. Int J Cancer. 2008;122:711–8. Lasota J, Dansonka-Mieszkowska A, Sobin LH, Miettinen M. A great majority of GISTs with PDGFRA mutations represent gastric tumors of low or no malignant potential. Labor Invest. 2004;84:874–883. Lee CK, Chung IK, Lee SH, et al. Endoscopic partial resection with the unroofing technique for reliable tissue diagnosis of upper GI subepithelial tumors originating from the muscularis propria on EUS (with video). Gastrointest Endosc. 2010 Jan;71(1):188-94. Maleddu A, Pantaleo MA, Nannini M, Biasco G. The role of mutational analysis of KIT and PDGFRA in gastrointestinal stromal tumors in a clinical setting. J Transl Med. 2011 May 23;9:75. Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors: recent advances in understanding of their biology.Hum Pathol. 1999;30(10):1213-20. 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. 2005;29(1):52-68. Rossi S, Gasparotto D, Toffolatti L, Pastrello C, Gallina G, Marzotto A, Sartor C, Barbareschi M, Cantaloni C, Messerini L, Bearzi I, Arrigoni G, Mazzoleni G, Fletcher JA, Casali PG, Talamini R, Maestro R, Dei Tos AP. Molecular and clinicopathologic characterization of gastrointestinal stromal tumors (GISTs) of small size. Am J Surg Pathol. 2010;34(10):1480-91. Rubin BP, Heinrich MC, Corless CL. Gastrointestinal stromal tumour. Lancet. 2007 May 19;369(9574):1731-41. Review. Erratum in: Lancet. 2007 Aug 4;370(9585):388. Sepe PS, Brugge WR. A guide for the diagnosis and management of gastrointestinal stromal cell tumors. Nat Rev Gastroenterol Hepatol. 2009; 6(6):363-71. Søreide K. Cancer biology of small gastrointestinal stromal tumors (<2 cm): What is the risk of malignancy? Eur J Surg Oncol. 2017 Jul;43(7):1344-1349. Soft Tissue Sarcoma, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2016;14:758-786. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/20523 | - |
| dc.description.abstract | 胃腸基質瘤（Gastrointestinal stromal tumor, GIST）是常見的胃表皮下腫瘤。目前內視鏡超音波被廣泛利用於評估胃表皮下腫瘤，而內視鏡超音波對於診斷胃腸基質瘤也有頗佳的敏感度。當例行性內視鏡檢查意外發現胃表皮下腫瘤的情形愈來愈多，在後續內視鏡超音波臆測為小型胃腸基質瘤的機會也就愈高。然而現今美國國家癌症資訊網（NCCN）治療建議對於小型胃部胃腸基質瘤（小於2公分）的處置仍有爭議，也沒有前瞻性的研究來認可現行以內視鏡超音波進行規則追蹤的策略。
在之前的回溯性研究，以50個小於3公分的內視鏡超音波臆測胃部胃腸基質瘤的病患為研究對象，發現大於1.4公分的內視鏡超音波臆測胃部胃腸基質瘤較會在追蹤過程中持續進展增大。另外，小型胃部胃腸基質瘤之腫瘤增長相關的重要因子，包括了腫瘤的初始尺寸及不規則的腫瘤邊緣。這類內視鏡超音波臆測胃部胃腸基質瘤研究，因為小型表皮下腫瘤組織取樣不易，無法有完整的組織診斷為胃腸基質瘤，所以結論推估上有著一定的限制。此外，考慮到一般常被論述的「組織增生－腫瘤贅生」時序性，小型胃腸基質瘤被視為自我限制生長能力的良性病灶，還是已經算是惡性胃腸基質瘤的發展早期，現階段仍有爭議。此研究的目標有兩個，其一在於試圖找出較佳且安全的診斷策略，以提高小型胃腸基質瘤的組織診斷率；其二在於前瞻性的驗證這類小型胃腸基質瘤中病理與分子的特徵。我們期待這些研究上的努力，能夠為小型胃腸基質瘤建立更好的處置流程。 | zh_TW |
| dc.description.abstract | Gastrointestinal stromal tumors (GISTs) account for the largest proportion of gastric subepithelial tumors (SETs). Endoscopic ultrasound (EUS) is widely used for evaluating gastric SETs, and is sensitive to detect those locate at the fourth layer, name as EUS-suspected gastric GISTs. Since screening endoscopy becomes common, more SETs are discovered and the incidence of EUS-suspected gastric GISTs are increasing. Under current National Comprehensive Cancer Network (NCCN) guidelines, the management of small GISTs with size less than 2 cm remains controversial. There is also no prospective study to assess the interval of EUS surveillance of small GIST.
In a retrospective study, 50 patients with EUS-suspected gastric GISTs of sizes less than 3 cm were followed up by EUS at least twice over a period of more than 24 months, subgroup larger than 1.4cm was associated with significant progression. Other important factors of tumor progression include initial tumor size and irregular tumor border. Due to challenging tissue acquisition and lack of definite pathological diagnosis, current studies about EUS-suspected gastric GISTs have limitations. Concerning possible hyperplasia-neoplasia sequence, whether small GISTs are considered as self-limiting benign lesion or pre-malignant lesion are still under debate. The aims of our study are to (i) validate the endoscopic incisional biopsy as an alternative and safe method for diagnostic yield of small fourth layer subepithelial tumors, particularly GISTs, (ii) study the pathologic and molecular characteristics of small gastric GISTs prospectively. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-08T02:51:46Z (GMT). No. of bitstreams: 1 ntu-106-P04421011-1.pdf: 3121728 bytes, checksum: 67fb851dcdfd075dc3edfdfd43d5907c (MD5) Previous issue date: 2017 | en |
| dc.description.tableofcontents | 第一章 Introduction……………………………………………………………… 1
第二章 Materials and Methods……………………………………… 3 第一節 Patient population..…………………………………… 3 第二節 Incisional biopsy……………………………………… 3 第三節 Histological diagnosis……………………………… 3 第四節 Molecular analysis…………………………………… 3 第三章 Results…………………………………………………………… 5 第一節 Clinicopathologic findings ……………………… 5 第二節 Mutation analysis of KIT and PDGFRA………… 6 第三節 Complications…………………………………………… 6 第四章 Discussions…………………………………………………… 7 第五章 Conclusions………………………………………………… 10 References……………………………………………………………… 11 Table 1…………………………………………………………………… 14 Table 2…………………………………………………………………… 15 Table 3…………………………………………………………………… 16 Figure 1, Figure 2………………………………………………… 17 Figure 3, Figure 4………………………………………………… 18 Figure 5, Figure 6a, Figure 6b, Figure 6c……………… 19 Figure 7…………………………………………………………………… 20 | |
| dc.language.iso | en | |
| dc.title | 內視鏡超音波臆測小型胃部胃腸基質瘤之臨床病理評估 | zh_TW |
| dc.title | Clinicopathologic Assessment of Small Endoscopic Ultrasound-suspected Gastric Gastrointestinal Stromal Tumors | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 105-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.coadvisor | 鄭祖耀(Tsu-Yao Cheng) | |
| dc.contributor.oralexamcommittee | 楊宏志(Hung-Chih Yang) | |
| dc.subject.keyword | 胃腸基質瘤,表皮下腫瘤,內視鏡超音波,黏膜下切開切片術,胃平滑肌瘤, | zh_TW |
| dc.subject.keyword | gastrointestinal stromal tumor,subepithelial tumor,endoscopic ultrasound,incisional biopsy,gastric leiomyoma, | en |
| dc.relation.page | 20 | |
| dc.identifier.doi | 10.6342/NTU201702233 | |
| dc.rights.note | 未授權 | |
| dc.date.accepted | 2017-08-14 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
| 顯示於系所單位： | 臨床醫學研究所 | |
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