Matthews B D, Joels C S, Kercher K W, Heniford B T
Department of General Surgery, Carolinas Medical Center, Charlotte, NC 28203, USA.
Minerva Chir. 2004 Jun;59(3):219-31.
Gastrointestinal stromal tumors (GIST) comprise a rare group of neoplasms of unpredictable malignant potential with an annual incidence of 4/million persons. The stomach is the most common site of occurrence in the gastrointestinal tract. A combination of prognostic factors (patient age, histologic grade, mitotic rate, tumor size, and DNA analysis) have been utilized to predict their biologic behavior. Lymphatic spread of gastrointestinal stromal tumors is uncommon therefore a formal lymph node dissection is not standard surgical management. Consequently, complete surgical resection of the primary tumor is the most definitive treatment. An increasing number of cases have been reported utilizing a combination of laparoscopic and endoscopic techniques to resect these tumors. The manuscript will characterize the biologic behavior of gastrointestinal stromal tumors of the stomach, discuss the preoperative evaluation and minimally invasive surgical management of these patients, and review recent, encouraging adjuvant treatment strategies.
胃肠道间质瘤(GIST)是一组罕见的肿瘤,其恶性潜能难以预测,年发病率为每百万人4例。胃是胃肠道中最常见的发病部位。多种预后因素(患者年龄、组织学分级、有丝分裂率、肿瘤大小和DNA分析)已被用于预测其生物学行为。胃肠道间质瘤的淋巴转移并不常见,因此规范的淋巴结清扫术并非标准的手术治疗方式。因此,完整切除原发肿瘤是最确切的治疗方法。越来越多的病例报告采用腹腔镜和内镜技术联合切除这些肿瘤。本文将描述胃胃肠道间质瘤的生物学行为,讨论这些患者的术前评估和微创外科治疗,并回顾近期令人鼓舞的辅助治疗策略。