Agaimy A, Hartmann A
Institut für Pathologie, Universitätsklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen.
Pathologe. 2010 Oct;31(6):430-7. doi: 10.1007/s00292-010-1354-6.
The majority of gastrointestinal stromal tumours (GISTs) present as solitary gastrointestinal masses in adults aged 50-70 years. A small subset of GISTs (≤5%) occurs in the setting of familial or idiopathic multitumour syndrome. In decreasing order of frequency, neurofibromatosis Recklinghausen (NF-1), Carney triad (gastric GIST, pulmonary chondroma and extra-adrenal paraganglioma), familial GIST syndromes resulting from germline mutations in c-Kit/PDGFRA and the Carney-Stratakis syndrome (hereditary GIST paraganglioma syndrome caused by germline mutations in the mitochondrial tumour suppressor gene pathway involving the succinate dehydrogenase subunits SDHD, SDHC and SDHB) represent the four most important GIST syndromes characterized to date. Since affected patients and their family members require special treatment and/or counseling and follow-up, early diagnosis and precise classification of this likely still underdiagnosed diseases is of the utmost importance. This review summarizes the pertinent clinicopathological and molecular features of the main GIST syndromes to facilitate their diagnosis and distinction from their non-syndromic mimics.
大多数胃肠道间质瘤(GIST)表现为50至70岁成年人的孤立性胃肠道肿块。一小部分GIST(≤5%)发生于家族性或特发性多肿瘤综合征背景下。按发生频率递减顺序,神经纤维瘤病(Recklinghausen型NF-1)、卡尼三联征(胃GIST、肺软骨瘤和肾上腺外副神经节瘤)、由c-Kit/PDGFRA种系突变导致的家族性GIST综合征以及卡尼-斯特拉塔基斯综合征(由涉及琥珀酸脱氢酶亚基SDHD、SDHC和SDHB的线粒体肿瘤抑制基因途径种系突变引起的遗传性GIST副神经节瘤综合征)是迄今已明确的四种最重要的GIST综合征。由于患病患者及其家庭成员需要特殊治疗和/或咨询及随访,尽早诊断并准确分类这些可能仍诊断不足的疾病至关重要。本综述总结了主要GIST综合征相关的临床病理和分子特征,以助于其诊断并与非综合征性相似疾病相鉴别。