Department of Pathology, University of South Alabama Medical Center, Mobile, AL 36617, USA.
Arch Pathol Lab Med. 2010 Jan;134(1):134-41. doi: 10.5858/2008-0083-RSR2.1.
Gastrointestinal stromal tumors are mesenchymal neoplasms with a spectrum of histologic appearances and biologic activity. The morphologic classification of these lesions has evolved over time, and molecular analysis has led to a better understanding of their nature. The histologic differential diagnosis for these lesions is broad and includes many spindle cell lesions of the gastrointestinal tract, including neoplasms of true smooth muscle and neural origin, proliferating fibrous lesions, metastatic neoplasms, and primary sarcomas of vascular and adipose origin. Immunohistochemical studies that include CD117 have become invaluable in the classification of mesenchymal lesions arising in the gastrointestinal tract. Treatment of gastrointestinal stromal tumors has historically been involved surgery, but the use of the chemotherapeutic agent imatinib mesylate for advanced disease has made accurate classification even more important. The molecular features have not only allowed us to understand the pathogenesis of these tumors but also have proven to be associated with response to kinase inhibitors.
胃肠道间质瘤是一种具有多种组织学表现和生物学活性的间叶性肿瘤。这些病变的形态学分类随着时间的推移而不断发展，分子分析也使人们对其本质有了更好的理解。这些病变的组织学鉴别诊断范围很广，包括胃肠道的许多梭形细胞病变，包括真正的平滑肌和神经来源的肿瘤、增殖性纤维病变、转移性肿瘤以及血管和脂肪来源的原发性肉瘤。包括 CD117 在内的免疫组织化学研究在胃肠道间叶性病变的分类中变得非常有价值。胃肠道间质瘤的治疗历来涉及手术，但化疗药物甲磺酸伊马替尼治疗晚期疾病使得准确分类变得更加重要。分子特征不仅使我们能够了解这些肿瘤的发病机制，而且还证明与激酶抑制剂的反应有关。
