University Hospital Marqués de Valdecilla, Santander, Cantabria, Spain.
Clin Transl Oncol. 2010 Feb;12(2):100-12. doi: 10.1007/S12094-010-0476-x.
Because of their well known origin in gene mutations and a revolutionary therapy by means of molecular targets, gastrointestinal stromal tumours (GIST) constitute a plentiful and paradigmatic model of translational investigation, resulting in an avalanche of exponential growth data. In this article, we focus on what we consider to be hot spots in GIST at present. A wide spectrum of events is approached, extending from subtle pathogenic mechanisms at a molecular level (gene mutations and their implications for cell receptors with subsequent activation of signalling pathways) to more practical problems facing diagnosis (molecular markers, role of biopsy), prognosis (risk stratification systems) and different therapeutic aspects (laparoscopic surgery, role of surgery in advanced disease, response criteria, adjuvant and neoadjuvant therapy, treatment for progressing and recurrent disease, therapy directed on mutation analysis and new developments, among others). The review has been endorsed by level of evidence evaluation through a recognised pattern to assist in teaching, and a final summary of recommendations and a management algorithm are included.
由于其在基因突变和革命性的分子靶向治疗方面的显著起源，胃肠道间质瘤（GIST）构成了转化研究的丰富而典型的模型，产生了大量呈指数增长的数据。在本文中，我们关注的是目前 GIST 的热点问题。广泛的事件正在被探讨，从分子水平上微妙的发病机制（基因突变及其对细胞受体的影响，随后激活信号通路）扩展到更实际的诊断问题（分子标志物、活检的作用）、预后（危险分层系统）和不同的治疗方面（腹腔镜手术、晚期疾病的手术作用、反应标准、辅助和新辅助治疗、进展和复发性疾病的治疗、针对突变分析和新进展的治疗等）。通过一种公认的模式进行证据评估来支持教学，包括建议的总结和管理算法。
