Paparelli C, Cavallaro G, Basso L, Polistena A, Mingazzini P L, De Toma G
Department of Surgery, P. Valdoni Policlinico Umberto I, University La Sapienza, Rome, Italy.
Minerva Chir. 2006 Dec;61(6):537-40.
Gastrointestinal stromal tumors are rare neoplasms arising from mesenchymal cells of the gastrointestinal tract, that strongly express a class III receptor tyrosine kinase, called KIT, due to some mutations in the KIT proto-oncogene. Two thirds of GISTs are found in the stomach, 20% to 50% in the small bowel (one third in the duodenum), and 5% to 15% in colon and rectum; GISTs, however, may rarely be found also in the oesophagus, omentum, mesentery or the retroperitoneum. Their treatment is strictly surgical, and only R0 resection can achieve good
Treatment with Imatinib seems to be promising in case of unresectable or metastatic GIST, even if some trials are studying its effects after curative resection. GIST of the mesocolon are rare, and as in the other locations, require extensive surgery. The Autohrs report a case of giant malignant GIST arising from transverse mesocolon, treated by en-bloc resection of the tumor with a segment of transverse colon and great omentum.
胃肠道间质瘤是起源于胃肠道间充质细胞的罕见肿瘤,由于KIT原癌基因的某些突变,其强烈表达一种III类受体酪氨酸激酶,称为KIT。三分之二的胃肠道间质瘤发生在胃,20%至50%发生在小肠(十二指肠占三分之一),5%至15%发生在结肠和直肠;然而,胃肠道间质瘤也很少见于食管、网膜、肠系膜或腹膜后。其治疗严格采用手术方式,只有R0切除才能取得良好效果。
伊马替尼治疗不可切除或转移性胃肠道间质瘤似乎很有前景,尽管一些试验正在研究其在根治性切除后的效果。结肠系膜胃肠道间质瘤罕见,与其他部位一样,需要广泛手术。奥托尔斯报告了一例起源于横结肠系膜的巨大恶性胃肠道间质瘤病例,通过将肿瘤与一段横结肠和大网膜整块切除进行治疗。