Iarŭmov N, Velev G, Todorov G, Lukanova Ts, Angelov K, Gribnev P, Sokolov M, Toshev S
Khirurgiia (Sofiia). 2007(4):27-32.
Gastrointestinal stromal tumors (GIST) are specific, generally Kit (CD117) - positive, mesenchymal tumors of the gastrointestinal tract encompassing a majority of tumors previously considered gastrointestinal smooth muscle tumors. They are believed to originate from interstitial cells of Cajal or related stem cells. Diagnosis is based on histological and immunohistochemical examination, and these rare tumors are characterized by c-kit (CD117) staining. We present an analysis of clinical presentation and course, surgical management and pathological features of 11 patients with gastrointestinal stromal tumors treated in our institution from 2002 to 2007. 2 patients with malignant retroperitoneal GIST had disease progression/recurrence and died. They received adjuvant imatinib therapy. 9 patients are disease free on the 3-d year of the follow-up. Our results confirm that in stromal tumors complete surgical resection remains the mainstay of treatment in localized gastrointestinal stromal tumors. Complete removal of the tumor is often curative in localized gastrointestinal stromal tumors and is always recommended. Clinically, their behavior is difficult to predict, and mitotic count and tumor size seem to be the most effective prognostic factors. It is conceivable that treatment and prognosis of metastatic and non - resectable gastrointestinal stromal tumors, as well as the adjuvant treatment of high-risk, radically excised gastrointestinal stromal tumors will be strongly impacted by the c-kit target therapy.
胃肠道间质瘤(GIST)是一种特殊的、通常为Kit(CD117)阳性的胃肠道间叶性肿瘤,涵盖了大多数以前被认为是胃肠道平滑肌肿瘤的肿瘤。它们被认为起源于 Cajal 间质细胞或相关干细胞。诊断基于组织学和免疫组化检查,这些罕见肿瘤的特征是 c-kit(CD117)染色。我们对2002年至2007年在我院接受治疗的11例胃肠道间质瘤患者的临床表现、病程、手术治疗及病理特征进行了分析。2例恶性腹膜后 GIST 患者出现疾病进展/复发并死亡。他们接受了辅助伊马替尼治疗。9例患者在随访第3年时无疾病。我们的结果证实,在间质瘤中,完整的手术切除仍然是局限性胃肠道间质瘤治疗的主要方法。对于局限性胃肠道间质瘤,完整切除肿瘤通常可治愈,因此一直被推荐。临床上,它们的行为难以预测,有丝分裂计数和肿瘤大小似乎是最有效的预后因素。可以想象,c-kit 靶向治疗将对转移性和不可切除的胃肠道间质瘤的治疗和预后,以及高危、根治性切除的胃肠道间质瘤的辅助治疗产生重大影响。