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オリジナル原稿
平滑筋肉腫(LMS)は、小腸の稀な腫瘍であり、筋肉粘膜または固有筋から生じる。小腸におけるLMS発生の最も一般的な部位は、空腸であり、回腸および十二指腸がそれに続く。その一般的な徴候には、腹部腫瘤、腹痛、および顕著な消化管出血などがある。LMSは、主に60歳代において起こり、男性がわずかに多い。小腸腫瘍の術前診断は困難であり、特に良性腫瘍と悪性腫瘍を区別することは難しい。最近の文献レビューにおいて、コンピュータ断層撮影(CT)および磁気共鳴(MR)腸運動記録および高位浣腸法が小腸におけるLMSの評価に良い手法であることが明らかになった。CTおよびMRの両方の画像検査で見逃す可能性のある表在性病変は、水カプセル内視鏡検査で検出することができ、その検出率は約 80% である。組織学的に、LMSは消化管間質性腫瘍に類似している。しかしながら、LMSは、免疫組織化学的にCD117およびCD34に対して陰性であり、平滑筋アクチンおよびデスミンに対して陽性である。LMSのサイズが5cmを超えると通常、血行性に、肝臓(65%)、他の消化器官(15%)、および肺(4%)に拡がる。リンパ系(13%)または腹膜経路(18%)を介して拡がることもある。小腸におけるLMSの唯一の有効な治療法は手術である。原発腫瘍は、腸間膜を広く切除して、根治的に切除されるべきである。化学療法に対するLMSの反応は不明であり、放射線療法は治療において役割を果たさない。 したがって、可能であれば、転移切除術を検討すべきである。 ドセタキセルとゲムシタビンの組み合わせを含む第II相および第III相の大規模試験では、LMS(大半が子宮起源)に対する印象的な奏効率が報告されている。しかし、複数の研究では、この組み合わせの有効性を確認することができなかった。最近、トラベクテジンは、LMSに対して最大56%の奏効率を示し、アントラサイクリンとイホスファミドの組み合わせによる治療失敗後の極めて進行したLMSおよび転移性LMSに対して、特に有用であると考えられている。
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Leiomyosarcoma are rare tumors of small intestine which arise from the muscularis mucosa or muscularis propria. The most common site of LMS in the small intestine is jejunum followed by ileum and then duodenum. The common presentations include abdominal mass, abdominal pain or overt gastrointestinal bleeding. They are mainly seen in 6th decade of life with slight male preponderance. Preoperative diagnosis of small intestinal tumors is difficult, especially differentiating between benign and malignant tumors. For LMS in small intestine, recent review of literature revealed that CT and MRI-enterography and enteroclysis are good options.Cases of superficial lesion which can be missed by both CT and MRI, can however be detected by water capsule endoscopy with a detection rate of around 80%. Histologically LMS resembles like GIST, however they are CD117 and CD34 negative by immunohistochemistry and positive for smooth muscle antigen (SMA) and desmin. When these tumors are more than 5 cm they commonly spread hematogenously to liver (65%), other GI organs (15%), lung(4%). It also has the capability to spread via lymphatics (13%) or via peritoneal route (18%). The only effective treatment for small intestine LMS is surgery. The primary tumor should be excised radically, including a wide resection of the mesentry. Response to chemotherapy is doubtful, and there is no role for radiotherapy. Therefore, metastasectomy, if possible, should be considered. Large phase II and III studies combining docetaxel and gemcitabine yielded impressive response rates in LMSs (mostly of uterine origin). However, others were not able to confirm the efficacy of this combination. Recently, trabectedin showed response rates up to 56% in LMSs, and it appeared to be especially useful in far-advanced and metastatic LMSs after failure of the combination of anthracyclines and ifosfamide.
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Leiomyosarcoma (LMS) is a rare tumors of small intestine which arise from the muscularis mucosa or muscularis propria. The most common site of LMS in the small intestine is the jejunum, followed by the ileum and duodenum. The common presentations include abdominal mass, abdominal pain, and overt gastrointestinal bleeding. They are mainly observed in 6th decade of life, with slight male preponderance. The preoperative diagnosis of small intestinal tumors is difficult, especially in terms of differentiating between benign and malignant tumors. For LMS in the small intestine, a recent review of literature revealed that computed tomography (CT) and magnetic resonance (MR) enterography and enteroclysis are good detection options. Cases of superficial lesions, which can be missed by both CT and MR imaging, can however be detected by water capsule endoscopy, with a detection rate of approximately 80%. Histologically, LMS resembles gastrointestinal stromal tumor; however, it is negative for CD117 and CD34 and positive for smooth muscle actin and desmin on immunohistochemistry. When these tumors are more than 5 cm, they commonly spread hematogenously to liver (65%), other gastrointestinal organs (15%), and the lungs (4%). They also have the capability to spread via the lymphatic system (13%) or peritoneal route (18%). The only effective treatment for LMS in the small intestine is surgery. The primary tumor should be excised radically, including a wide resection of the mesentry. Response to chemotherapy is unknown, and there is no role of radiotherapy. Therefore, metastasectomy, if possible, should be considered. Large phase II and III studies combining docetaxel and gemcitabine yielded impressive response rates for LMSs (mostly of uterine origin). However, others were not able to confirm the efficacy of this combination. Recently, trabectedin showed response rates up to 56% for LMSs, and it appeared to be especially useful in far-advanced and metastatic LMSs after failure of the combination of anthracyclines and ifosfamide.
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Leiomyosarcoma (LMS)1 areis
a rare tumors of small intestine which arise from the muscularis
mucosa or muscularis propria. The most common site of LMS in the small
intestine is the jejunum, followed by the ileum
and then duodenum. The common
presentations include abdominal mass, abdominal pain,
and2 or overt gastrointestinal
bleeding. They are mainly seenobserved3 in 6th decade of life with slight male
preponderance. The Ppreoperative
diagnosis of small intestinal tumors is difficult, especially in terms of differentiating between benign and
malignant tumors. For LMS in the small
intestine, a recent review of literature
revealed that computed tomography (CT) and magnetic
resonance (MR)I- enterography
and enteroclysis are good detection4 options. Cases of superficial lesions, which can be missed by both CT and MRI imaging,
can however be detected by water capsule endoscopy,
with a detection rate of aroundapproximately 80%. Histologically, LMS resembles likegastrointestinal stromal tumorGIST,;
however they areit is negative for5 CD117 and CD34 negative by immunohistochemistry and positive for
smooth muscle antigenactin6 (SMA)
and desmin on immunohistochemistry. When
these tumors are more than 5 cm, they
commonly spread hematogenously to liver (65%), other gastrointestinalGI organs
(15%), and the lungs (4%). It They
also has have the capability to spread
via the lymphatics system (13%)
or via peritoneal route (18%). The only
effective treatment for LMS in the small
intestine LMS 7is surgery. The primary
tumor should be excised radically, including a wide resection of the mesentry.
Response to chemotherapy is doubtfulunknown, and there is no role for8of
radiotherapy. Therefore, metastasectomy, if possible, should be
considered. Large phase II and III studies combining docetaxel and
gemcitabine yielded impressive response rates forin LMSs (mostly of uterine origin). However,
others were not able to confirm the efficacy of this combination. Recently,
trabectedin showed response rates up to 56% forin LMSs, and it appeared to be especially useful
in far-advanced and metastatic LMSs after failure of the combination of
anthracyclines and ifosfamide.
- [SME] 初回で使用されたさいの略語で、これは本文中でさらに使用されています。
- [語句の選択] 文脈に応じた、より的確な語の使用
- [語句の選択] より的確な語が使用されました
- [誤訳] 誤訳が特定されました。ここでは、"or "の使用は、原文に従って意味を変えます。
- [語の選択] 文脈に沿ったより的確な語の使用
- [明確さと読みやすさ] 正しい専門用語を使用し、文章をよりわかりやすく、読みやすくするために言い換えました。
- [訳抜け] 単語レベルでの訳抜けが確認されました
- [明確さと読みやすさ] 文章をよりわかりやすくするために再構成しました。
- [言語] 文章構成を見直し、読みやすくしました。
- [専門用語の選択] 正しい専門用語が使用されていました
- [言語] 的確な語を使用し、言葉を充実させます
- [明確さ] 文章をより明確にするために言い換えました。
- [誤訳] 前置詞の誤用で文の意味が変わります
- [文法] より的確な時制の使用
Leiomyosarcoma (LMS) is a rare small intestinal tumor, which arises from the muscularis mucosa or muscularis propria . The most common site of occurrence of LMS in the small intestine is the jejunum, followed by the ileum and duodenum. Its common manifestations include abdominal mass, abdominal pain, and overt gastrointestinal bleeding.. They are mainly observed in the 6th decade of life, with slight male preponderance. In general, the preoperative diagnosis of small intestinal tumors such as LMSs is difficult, especially in terms of differentiating between benign and malignant tumors. According to a recent literature review computed tomography (CT) and magnetic resonance (MR) enterography and enteroclysis are good modalities for the assessment of LMS. Superficial lesions, which can be missed by both CT and MR imaging, can be detected by water capsule endoscopy, with a detection rate of approximately 80%. Histologically, LMS resembles gastrointestinal stromal tumor; however, on immunohistochemical analysis, it has been found to be negative for CD117 and CD34 and positive for smooth muscle actin and desmin. When the size of LMS is more than 5 cm, it can hematogenously spread to the liver (65%), other gastrointestinal organs (15%), and the lungs (4%). It can also spread via the lymphatic system (13%) or peritoneal route (18%). The response of LMS to chemotherapy is unknown, and radiotherapy does not play a role in the treatment. Therefore, surgery is the only effective treatment for LMS in the small intestine. The primary tumor should be excised radically with wide resection of the mesentery. If possible, metastasectomy should be considered. Large phase II and III trials involving the combination of docetaxel and gemcitabine have reported impressive response rates for LMSs (mostly of uterine origin). However, some studies have not been able to confirm the efficacy of this combination. Trabectedin has recently showed response rates of up to 56% for LMSs, and it appeared to be particularly useful against far-advanced and metastatic LMSs after failure of anthracyclines and ifosfamide combination therapy.
修正ポイント |
このページでは、クロスチェッカーやネイティブチェッカー(校正者)が加えた修正変更を分かりやすいように色付きで紹介していますが、通常お客様には、修正変更履歴を残さず、最終版のみを納品しております。
Leiomyosarcoma (LMS)1 areis
a rare tumors of small intestineintestinal
tumor, which arises from the
muscularis mucosa or muscularis propria. The most common site of occurrence of 2LMS in the small intestine is the jejunum,
followed by the ileum and then duodenum. TheIts common presentations manifestations3 include abdominal mass, abdominal pain, and4 or overt gastrointestinal bleeding. They are mainly seenobserved5 in the 6th
decade of life with slight male preponderance. In
general, the The Ppreoperative diagnosis of small intestinal tumors such as LMSs is difficult, especially in terms of differentiating between benign and
malignant tumors. For LMS in the small
intestine, 6According to a recent review of
literature revealed that review computed tomography (CT) and magnetic
resonance (MR)I- enterography
and enteroclysis are good 7detection options. Cases of superficial modalities for the assessment of LMS. Superficial lesions, which
can be missed by both CT and MRI imaging, can however be
detected by water capsule endoscopy, with
a detection rate of aroundapproximately 80%. Histologically, LMS resembles like8gastrointestinal stromal tumorGIST,;
however, on immunohistochemical analysis,
they areit is has been found to be negative for9 CD117 and CD34 negative by immunohistochemistry and positive for
smooth muscle antigenactin (SMA)10
and desmin on immunohistochemistry.
When these tumors arethe size of LMS is 11more than 5 cm, they commonly spread
it can hematogenously spread to the
liver (65%), other gastrointestinalGI organs (15%), and
the lungs (4%). It TheyIt can also has have the capability to spread via the lymphatics
system (13%) or via peritoneal route (18%). The response of LMS to chemotherapy is unknown, and radiotherapy
does not play a role in the treatment. Therefore, surgery is the only
effective treatment for LMS in the small
intestine. LMS
12is surgery. The primary tumor should
be excised radically, including a with wide resection of the mesentry. Response to chemotherapy is doubtfulunknown, and
there is no role forof13 radiotherapy. Therefore, metastasectomy, iIf possible, metastasectomy
should be considered. Large phase II and III studies
combiningtrials involving the
combination of docetaxel and gemcitabine yieldedhave reported impressive response rates forin LMSs
(mostly of uterine origin). However, others weresome studies have14 not been
able to confirm the efficacy of this combination. Recently, trabectedinTrabectedin
has recently showed response rates of up
to 56% forin
LMSs, and it appeared to be especiallyparticularly useful inagainst far-advanced and metastatic LMSs after
failure of the combination of anthracyclines
and ifosfamide, combination therapy.