胃肠间质瘤研究新进展

Research on gastrointestinal stromal tumor:new advancement

胃肠间质瘤(GIST)是胃肠间质组织中最常见的恶性肿瘤,可发生于食管到肛门的任何部位,以胃和小肠最多见。c-kit原癌基因和血小板起源生长因子受体基因突变是GIST发生的关键因素。初步诊断主要依靠影像学,可帮助了解肿瘤发生的解剖部位、大小、与周围脏器的关系及有无转移等。确诊依靠病理学和免疫组织化学CD117蛋白过表达。GIST传统的治疗方法是外科切除,但目前主张手术联合分子靶向药物的综合治疗,对一些失去手术时机或复发转移的患者使用靶向药物可获得相对好的预后。近年来,随着分子生物学的发展,GIST的诊断和治疗迅速进步,本文针对其临床特征、免疫组织化学、鉴别诊断和治疗等几方面的最新研究进展作一综述。

Gastrointestinal stromal tumor （GIST） is the most common mesenchymal neoplasm of the gastrointestinal stromal tract. It arises anywhere from the esophagus to the anus in this tract, but most commonly from the stomach and small intestine. Mutations of the c-kit protooncogene and the platelet derived growth factor receptor genes are key events in GIST pathogenesis. Imageology plays an important role in providing supportive evidence for diagnosis, giving information of the tumor in its anatomical location, size, relationship with the neighborhood, and the presence or absence of metastasis. Its final diagnosis depends on pathology and immunohistochemistry with overexpression of CD117 protein. Surgical resection is regarded as conventional method of treatment. At present, combination of surgery with targeted drugs is advocated, and improved prognosis has been observed by using such drugs in those patients who suffered from nnresect- able tumors, recurrence or metastasis. In recent years, with the development of molecular medicine, there is a rapid progress in the diagnosis and treatment of GIST. The purpose of this paper is to review systemically the published data on clinical feature, immunohistochemistry, differential diagnosis, therapy and prognosis of GIST.