Reddy Rishindra M, Fleshman James W
Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Clin Colon Rectal Surg. 2006 May;19(2):69-77. doi: 10.1055/s-2006-942347.
Gastrointestinal stromal tumors (GISTs) are rare lesions that constitute the majority of mesenchymal tumors in the gastrointestinal tract. Within the colon and rectum, they represent 0.1% of all cancers. They can present with a variety of symptoms but are often asymptomatic. Although many lesions may be benign, up to half of patients develop recurrent disease within a few years. Almost all GISTs contain a mutation in the c-kit tyrosine kinase that leads to its constitutive activation and results in cell proliferation. This discovery has led to the immunostaining of the c-kit antigen (CD117) to distinguish GISTs from other malignancies. Radiologic examinations can be helpful in initial diagnosis and staging. Surgery is the best treatment for cure, but recent advances have led to the use of imatinib mesylate, a tyrosine kinase inhibitor, to treat metastatic or unresectable disease, or both. There are currently many clinical trials available to help treat GISTs.
胃肠道间质瘤(GISTs)是罕见的病变,占胃肠道间充质肿瘤的大多数。在结肠和直肠中,它们占所有癌症的0.1%。它们可表现出多种症状,但通常无症状。尽管许多病变可能是良性的,但高达一半的患者在几年内会出现疾病复发。几乎所有的胃肠道间质瘤都含有c-kit酪氨酸激酶突变,该突变导致其组成性激活并导致细胞增殖。这一发现导致了c-kit抗原(CD117)的免疫染色,以将胃肠道间质瘤与其他恶性肿瘤区分开来。放射学检查有助于初步诊断和分期。手术是治愈的最佳治疗方法,但最近的进展导致使用甲磺酸伊马替尼,一种酪氨酸激酶抑制剂,来治疗转移性或不可切除的疾病,或两者兼治。目前有许多临床试验可用于帮助治疗胃肠道间质瘤。