Wardelmann E, Hohenberger P, Reichardt P, Merkelbach-Bruse S, Schildhaus H-U, Büttner R
Institut für Pathologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127 Bonn.
Pathologe. 2010 May;31(3):195-8. doi: 10.1007/s00292-009-1270-9.
Gastrointestinal stromal tumors (GIST) are the most frequent mesenchymal tumors of the gastrointestinal tract. Two thirds of them are located in the stomach, another 30% occur in the small bowel, while the remaining tumors occur in the rectum or more rarely in the oesophagus. GIST most commonly grow from the smooth muscular layer towards the serosal surface whereas development towards to the mucosal layer is less frequent. In the latter case ulceration may occur, leading to gastrointestinal bleeding as the main symptom. However, the majority of GIST of the stomach are asymptomatic, resulting in large tumors on initial diagnosis. Most gastric GIST are not visible on endoscopy but may be diagnosed by endosonography. Due to their location in the outer layers of the tubular gastrointestinal tract biopsy is often hindered of even impossible. GIST of the stomach differ from tumors in other locations with regard to their morphology, molecular pathology and prognosis. This present article provides an overview of these differences also with regard to possible therapeutic consequences.
胃肠道间质瘤(GIST)是胃肠道最常见的间叶组织肿瘤。其中三分之二位于胃,另外30%发生于小肠,其余肿瘤发生于直肠,或更罕见于食管。GIST最常从平滑肌层向浆膜面生长,而向黏膜层发展的情况较少见。在后一种情况下,可能会发生溃疡,导致胃肠道出血为主要症状。然而,大多数胃GIST是无症状的,初诊时会发现较大肿瘤。大多数胃GIST在内镜检查时不可见,但可通过超声内镜诊断。由于它们位于管状胃肠道的外层,活检常常受到阻碍甚至无法进行。胃GIST在形态、分子病理学和预后方面与其他部位的肿瘤不同。本文还概述了这些差异及其可能的治疗后果。