Townsend Heather
From Atrium Health Carolinas Medical Center, Charlotte, North Carolina.
J Adv Pract Oncol. 2023 Sep;14(6):541-547. doi: 10.6004/jadpro.2023.14.6.7. Epub 2023 Sep 1.
Gastrointestinal stromal tumors (GISTs) are considered rare, but they are one of the most common malignant mesenchymal tumors within the gastrointestinal tract, affecting 4,000 to 6,000 adults in the United States each year. Because gastrointestinal bleeding is often the initial symptom, a thorough and timely diagnostic workup is imperative to accurately diagnose a potentially deadly tumor. Endoscopic ultrasound is helpful when working through a differential diagnosis of subepithelial lesions and can help identify which mucosal layer the lesion originates from, as well as the density of the lesion; however, surgical resection is the standard of care for the treatment of a resectable nonmetastatic GIST. For recurrent GISTs, metastatic disease, or GISTs not amendable to resection, tyrosine kinase inhibitors are frequently used, with imatinib being used in the first-line setting. A multimodal treatment approach is often necessary to increase the chances of a permanent cure.
胃肠道间质瘤（GISTs）被认为较为罕见，但却是胃肠道中最常见的恶性间叶组织肿瘤之一，在美国每年影响4000至6000名成年人。由于胃肠道出血往往是初始症状，因此进行全面且及时的诊断检查对于准确诊断这种潜在致命肿瘤至关重要。在对上皮下病变进行鉴别诊断时，内镜超声很有帮助，它可以帮助确定病变起源于哪一层黏膜以及病变的密度；然而，手术切除是可切除的非转移性GIST治疗的标准方法。对于复发性GIST、转移性疾病或无法进行切除的GIST，常使用酪氨酸激酶抑制剂，伊马替尼用于一线治疗。通常需要采取多模式治疗方法以增加实现永久治愈的机会。
