目的:探讨胃肠间质瘤(gastrointestinal stomal tumors,GIST)患者肿瘤组织中c-Kit和PDGFRA基因各亚型突变情况的研究。方法:应用直接测序方法检测65例GIST石蜡组织中c-Kit基因9、11、1 3和1 7外显子和P D G F R A基因1 2和1 8外显子突...目的:探讨胃肠间质瘤(gastrointestinal stomal tumors,GIST)患者肿瘤组织中c-Kit和PDGFRA基因各亚型突变情况的研究。方法:应用直接测序方法检测65例GIST石蜡组织中c-Kit基因9、11、1 3和1 7外显子和P D G F R A基因1 2和1 8外显子突变情况。结果:G I ST肿瘤组织中c-K i t基因总突变率为63.08%(41/65),外显子9、11、13和17的突变率分别为23.08%(15/65)、35.38%(23/65)、1.54%(1/65)和3.08%(2/65);c-Kit基因各外显子之间双重突变共2例(3.08%),其中9外显子与11外显子双重突变1例(1.54%),11外显子与17外显子双重突变1例(1.54%);c-Kit基因11号外显子内双重突变2例(3.08%),三重突变1例(1.54%)。PDGFRA基因总突变率为3.08%(2/65),均为外显子18突变。c-Kit基因和PDGFRA基因双突变共存型1例(1.54%),为c-Kit基因13外显子V654L点突变和PDGFR A基因18外显子D842V点突变。结论:GIST患者中c-Kit基因存在较高的突变率,尤其为9和11外显子突变,其基因突变亚型分类能指导精准医学下伊马替尼的肿瘤靶向治疗,PD GF R A基因突变率和存在两种及其以上突变发生的发生概率虽低但不容忽视。展开更多
A 12- year-old girl presented with a large abdominal tumor. At surgery, a huge pedunculated extraluminal tumor was found arising from the greater curvature of the stomach and invading the surrounding structures, and t...A 12- year-old girl presented with a large abdominal tumor. At surgery, a huge pedunculated extraluminal tumor was found arising from the greater curvature of the stomach and invading the surrounding structures, and there were also a submucosal tumor measuring 5× 4× 4 cm and multiple intramural nodules beside themain tumor. These lesions,which were removed with 1.0- cm surgical margins,were immunohistochemically positive for c-kit (CD117) and CD34. A diagnosis of gastrointestinal stromal tumor (GIST) was made. The huge size of the tumor (3.6 kg inweight and 36× 25× 25 cm in diameter), the invasion of the surrounding structures, and the increased mitotic figures indicated the GIST had malignant potential. Sequence analysis of the polymerase chain reaction product of RNAs from the tumor cells revealed a novel platelet-derived growth factor receptor α (PDGFRA) mutation, which would exhibit biologic consequences similar to those of the c-kitmutation. The patient underwent a 3- month course of imatinib mesylate as adjuvant chemotherapy because of the possible risk for tumor recurrence. She is now doing well without any evidence of recurrence or metastasis 25 months after the surgery. Only 9 cases of GIST have been reported in children, and a review of those cases revealed GISTs in children would be associated with a better prognosis than in adults and that one third of pediatric GISTs presented with intestinal obstruction in the newborn period.展开更多
文摘目的:探讨胃肠间质瘤(gastrointestinal stomal tumors,GIST)患者肿瘤组织中c-Kit和PDGFRA基因各亚型突变情况的研究。方法:应用直接测序方法检测65例GIST石蜡组织中c-Kit基因9、11、1 3和1 7外显子和P D G F R A基因1 2和1 8外显子突变情况。结果:G I ST肿瘤组织中c-K i t基因总突变率为63.08%(41/65),外显子9、11、13和17的突变率分别为23.08%(15/65)、35.38%(23/65)、1.54%(1/65)和3.08%(2/65);c-Kit基因各外显子之间双重突变共2例(3.08%),其中9外显子与11外显子双重突变1例(1.54%),11外显子与17外显子双重突变1例(1.54%);c-Kit基因11号外显子内双重突变2例(3.08%),三重突变1例(1.54%)。PDGFRA基因总突变率为3.08%(2/65),均为外显子18突变。c-Kit基因和PDGFRA基因双突变共存型1例(1.54%),为c-Kit基因13外显子V654L点突变和PDGFR A基因18外显子D842V点突变。结论:GIST患者中c-Kit基因存在较高的突变率,尤其为9和11外显子突变,其基因突变亚型分类能指导精准医学下伊马替尼的肿瘤靶向治疗,PD GF R A基因突变率和存在两种及其以上突变发生的发生概率虽低但不容忽视。
文摘A 12- year-old girl presented with a large abdominal tumor. At surgery, a huge pedunculated extraluminal tumor was found arising from the greater curvature of the stomach and invading the surrounding structures, and there were also a submucosal tumor measuring 5× 4× 4 cm and multiple intramural nodules beside themain tumor. These lesions,which were removed with 1.0- cm surgical margins,were immunohistochemically positive for c-kit (CD117) and CD34. A diagnosis of gastrointestinal stromal tumor (GIST) was made. The huge size of the tumor (3.6 kg inweight and 36× 25× 25 cm in diameter), the invasion of the surrounding structures, and the increased mitotic figures indicated the GIST had malignant potential. Sequence analysis of the polymerase chain reaction product of RNAs from the tumor cells revealed a novel platelet-derived growth factor receptor α (PDGFRA) mutation, which would exhibit biologic consequences similar to those of the c-kitmutation. The patient underwent a 3- month course of imatinib mesylate as adjuvant chemotherapy because of the possible risk for tumor recurrence. She is now doing well without any evidence of recurrence or metastasis 25 months after the surgery. Only 9 cases of GIST have been reported in children, and a review of those cases revealed GISTs in children would be associated with a better prognosis than in adults and that one third of pediatric GISTs presented with intestinal obstruction in the newborn period.
