Yucel Ahmet Fikret, Sunar Haldun, Hut Adnan, Kocakusak Ahmet, Pergel Ahmet, Barut Gul, Dikici Suleyman
Department of Surgery, Rize University Medical School, Rize, Istanbul, Turkey.
Case Rep Gastroenterol. 2010 Jul 26;4(2):250-260. doi: 10.1159/000319167.
The most common tumors derived from the mesenchyme of the gastrointestinal system are stromal tumors. These tumors are typically seen in the stomach and small intestine and less frequently in the colon, rectum and esophagus and are very rarely located outside the gastrointestinal system. Cure is provided with complete surgical resection with resection borders free of tumor. Tumor size, mitotic index, localization, CD117 and CD34 negativity in immunohistochemical studies, mucosal ulceration and presence of necrosis help to predict recurrence of the illness and patient survival. In high-risk gastrointestinal stromal tumors (GISTs) there is an increased rate of recurrence and shortened survival despite complete surgical resection. Thus patients with a high-risk GIST should be given adjuvant therapy with imatinib mesylate. Sunitinib maleate is another FDA-approved agent only for cases who cannot tolerate imatinib or who are resistant to it. Herein we present three cases with GISTs in different locations of the gastrointestinal system with a review of the relevant literature.
源自胃肠道间充质的最常见肿瘤是间质瘤。这些肿瘤通常见于胃和小肠,较少见于结肠、直肠和食管,极少位于胃肠道系统外。通过完整手术切除且切除边界无肿瘤可实现治愈。肿瘤大小、有丝分裂指数、定位、免疫组化研究中的CD117和CD34阴性、黏膜溃疡及坏死的存在有助于预测疾病复发和患者生存率。在高危胃肠道间质瘤(GIST)中,尽管进行了完整手术切除,但复发率仍会增加且生存期缩短。因此,高危GIST患者应接受甲磺酸伊马替尼辅助治疗。马来酸舒尼替尼是另一种仅被美国食品药品监督管理局(FDA)批准用于无法耐受伊马替尼或对其耐药患者的药物。在此,我们报告3例胃肠道系统不同部位GIST病例并复习相关文献。