胃肠道间质瘤的研究进展

Research Advancement of Gastrointestinal Stromal Tumor

胃肠道间质瘤(GIST)是胃肠道最常见的间质肿瘤,可能起源于胃肠壁的Cajal间质细胞或向Cajal细胞分化的干细胞。GIST中c-kit基因突变,导致KIT酪氨酸激酶持续活化,细胞增殖分化失控,最终形成肿瘤,与疾病的复发和预后相关。内镜检查是发现GIST的主要方法,最终确诊需要病理学诊断。肿瘤的大小和有丝分裂指数是评价良恶性或危险度的最主要指标。联合检测CD117(KIT蛋白)和CD34的表达,对GIST的诊断具有重要价值,其中KIT的敏感性和特异性较高。手术为治疗的首选方法。STI571(imatinib)为酪氨酸激酶抑制剂,应用于手术无法切除或已发生转移的GIST患者,已取得较好的疗效。

Gastrointestinal stromal tumors （GISTs）, the commonest mesenchymal tumors of the gastrointestinal tract, may originate from the pluripotential precursor cells like the interstitial cells of Cajal. Mutation of c-kit gene is very common in GIST, and results in continual activation of tyrosine kinase function, which causes uncontrolled cell proliferation and differentiation, and at last, tumorogenesis. The mutation is also relative to the recurrence and prognosis of GISTs. Endoscopy is the primary method to discover GISTs, but final diagnosis depends on pathological examination. The size and mitotic count of the tumor play an important role in the diagnosis of the tumor. Surgical excision is the best treatment for GISTs. STI571 is a tyrosine kinase inhibitor, which may be effective for unresectable or metastatic GISTs.