了解胃间质瘤:从病理生理学到个性化治疗

Understanding Gastric GIST: From Pathophysiology to Personalized Treatment.

作者信息

Moga Doru-Florian-Cornel, Vlădoiu Gabriela, Frățilă Anca-Maria, Dan Andreea-Alina, Popa Daniel, Oprea Valentin

机构信息

Clinical Department of Surgery, Military Clinical Emergency Hospital Sibiu, 550024 Sibiu, Romania.

Department of Dental Medicine and Nursing, Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania.

出版信息

J Clin Med. 2024 Jul 9;13(14):3997. doi: 10.3390/jcm13143997.

Abstract

Gastric gastrointestinal stromal tumors (GISTs) represent a subset of gastrointestinal tumors predominantly found in the stomach. Despite their rarity, these tumors carry significant implications for patient health and management. GISTs are potentially malignant tumors with unpredictable progression. They originate from the interstitial cells of Cajal, which are positioned between the intramural neurons and the smooth muscle cells of the digestive tract. These tumors are characterized primarily by mutations in the c-Kit gene, as well as other mutations such as those in the platelet-derived growth factor receptor alpha (PDGFRA) gene. Our comprehensive search across five databases initially yielded 2976 articles. After eliminating 197 duplicates, we screened the titles and abstracts of 2779 articles, excluding 2692 for not meeting the inclusion criteria. During the full-text screening, 16 more articles were excluded. Ultimately, 71 papers met the inclusion criteria and were included in our analysis. Due to differences in study designs, inclusion criteria for patients, and reported outcomes, a meta-analysis was not conducted. The accurate diagnosis of GIST is established through histopathological examination and immunohistochemistry. Histopathologically, GISTs are classified into three main types: spindle cell, epithelioid, and mixed. The therapeutic management of GIST involves surgery, endoscopic treatment, and chemotherapy. The prognosis for GIST patients depends on various factors, including risk category, disease stage, applied treatments, and recurrence post-treatment. A significant recent advancement comes from artificial intelligence, which can be increasingly involved in both the diagnosis and treatment of this tumor.

摘要

胃胃肠道间质瘤(GISTs)是胃肠道肿瘤的一个子集,主要发生在胃中。尽管它们罕见,但这些肿瘤对患者的健康和治疗具有重大影响。GISTs是具有不可预测进展的潜在恶性肿瘤。它们起源于Cajal间质细胞,这些细胞位于壁内神经元和消化道平滑肌细胞之间。这些肿瘤的主要特征是c-Kit基因的突变,以及其他突变,如血小板衍生生长因子受体α(PDGFRA)基因的突变。我们对五个数据库进行的全面检索最初产生了2976篇文章。在消除197篇重复文章后,我们筛选了2779篇文章的标题和摘要,排除了2692篇不符合纳入标准的文章。在全文筛选过程中,又排除了16篇文章。最终,71篇论文符合纳入标准并被纳入我们的分析。由于研究设计、患者纳入标准和报告结果的差异,未进行荟萃分析。GIST的准确诊断通过组织病理学检查和免疫组织化学来确定。在组织病理学上,GIST分为三种主要类型:梭形细胞型、上皮样型和混合型。GIST的治疗管理包括手术、内镜治疗和化疗。GIST患者的预后取决于多种因素,包括风险类别、疾病阶段、应用的治疗方法以及治疗后的复发情况。最近一项重大进展来自人工智能,它在这种肿瘤的诊断和治疗中发挥着越来越重要的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e01c/11277334/2bd37599c56f/jcm-13-03997-g001.jpg

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