Objective To describe pharmacokinetic of imatinib in a cohort of gastrointestinal stromal tumor (GIST) patients in routine clinical care from West China Hospital of Sichuan University. Methods The imatinib trough concentration (Cmin) in 42 patients with GIST who were taking imatinib in routine clinical care setting in West China Hospital from 2010 to 2016 was measured. The clinical features and follow-up data were collected. Results The mean imatinib Cmin in 42 patients was 1 757 μg/L (199–7 435 μg/L), 10 of 42 patients presented with Cmin values was lower than 1 000 μg/L. The imatinib Cmin of 18 patients received an imatinib dose of 300 mg/d or 24 patients treated with 400 mg/d imatinib was (1 313±479) μg/L and (1 775±1 520) μg/L, respectively (P=0.222), but the rate of low Cmin (lower than 1 000 μg/L) in the two different dose groups had no significant difference (P=0.347). In Cox regression, no statistically significant association between the low Cmin and the time to progression of GIST could be demonstrated 〔HR=0.171, 95%CI：(0.106, 12.990),P=0.898〕. Conclusion The preliminary results of limited cases in this study show that some GIST patients are systematically underexposed in routine clinical care, an individualized treatment based on monitoring of imatinib Cmin is likely to be more efficient than a fixed-dose treatment.
Objective To determine the influence of combinative assessment of transrectal ultrasound (TRUS) and serum amyloid A protein (SAA) on the assessment of preoperative staging selection of operative procedures in the middle and lower rectal cancer. Methods Prospectively enrolled 130 patients, who diagnosed definitely as middle and lower rectal cancer at West China Hospital of Sichuan University from June 2008 to February 2009 were randomly assigned into two groups with 65 participants, respectively. In one group named TRUS combined SAA group, both TRUS and SAA combinative assessment were made for the preoperative evaluation. In another group named TRUS group, only the preoperative TRUS was made. The preoperative staging and predicted operative procedures were compared with postoperative pathologic staging and practical operation program, respectively.Results Of 118 patients with rectal cancer were actually included into TRUS combined SAA group (n=59) and TRUS group (n=59). The baselines of characteristics of two groups were basically identical. For TRUS combined SAA group， the accuracies of preoperative T and N staging were 79.7% (47/59) and 77.8% (42/54) respectively; For TRUS group the corresponding rates were 86.4% (51/59) and 57.7% (30/52), respectively. There was no statistically significant difference of the accuracy of preoperative T staging （P=0.609） while preoperative N staging had statistical difference (P=0.027) between two groups. There was a statistically significant difference of the accuracy of prediction to operative procedures in two groups 〔96.6% (57/59) vs. 83.1% (49/59), P=0.015〕. The preoperative T staging was related to the selection of operative procedures (P=0.037) when analyzing the relationship between the operative procedures and the multiple clinicopathological factors in middle and lower rectal cancer. ConclusionCombinative assessment of TRUS and SAA could improve the accuracy of preoperative staging in middle and lower rectal cancer, thus provide higher predictive coincidence rate to operative procedures for surgeon.
Carney triad is a rare tumor syndrome with few reports. This case showed the enhanced CT and MRI images of a rare young woman patient with Carney triad (containing gastric stromal tumor, renal cell carcinoma, adrenal pheochromocytoma, and pulmonary chondrosarcoma), which is intended to provide a reference for clinical diagnosis and differential diagnosis. This case reminds the radiologists and clinicians that the patients with a history of primary gastrointestinal stromal tumor and neoplastic lesions occurring at specific sites (pulmonary chondrosarcoma, adrenal pheochromocytoma, renal cell carcinoma, etc.) need to be alerted to the possibility of combining with Carney triad.