Gastrointestinal stromal tumors: new progress, new questions
Gastrointestinal stromal tumors: new progress, new questions
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DOI：
10.1097/00001574-200409000-00011
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发表时间：
2004-09-01
影响因子：
2.5
通讯作者：
Nickl, NJ
中科院分区：
文献类型：
--
作者：
Nickl, NJ
胃肠道间质瘤是一种少见但重要的胃肠道间叶肿瘤。它们偶尔会遇到常规内镜检查，当识别可能会出现诊断困境。幸运的是，恶性形式很少见，通常具有侵略性，对治疗有抵抗力。本文综述了近几年来胃肠道间质瘤的诊断、治疗及发病机制的研究进展，并对内镜超声（EUS）在胃肠道黏膜下肿瘤诊断中的应用进行了综述。EUS还可以引导这些病变的针吸以获得诊断组织。膜转导受体KIT突变的发现，使人们对这种肿瘤的发病机制有了更深入的了解，甚至为其起源细胞提供了线索。此外，一种独特的治疗剂，伊马替尼，已被设计，具体目标异常KIT受体，并已证明在这种否则耐药恶性肿瘤显着的治疗效果。在发展GIST的共识定义和他们的腹腔镜surgery.SummaryMajor进展GIST的诊断和治疗已经发生在过去的几年中，并提高了所有形式的这种肿瘤的患者的护理。
Purpose of reviewGastrointestinal stromal tumors (GIST) are uncommon but important mesenchymal tumors of the GI tract. They are occasionally encountered on routine endoscopy examinations, when identification may present a diagnostic dilemma. The malignant form, fortunately rare, is typically aggressive and resistant to treatment. This paper reviews several important advances over the past several years in the diagnosis and treatment of GIST, as well as in understanding of its pathogenesis.Recent findingsEndoscopic ultrasound (EUS) has emerged as the diagnostic measure of choice in the evaluation of submucosal tumors of the GI tract, and EUS criteria have been devised for the identification and characterization of GIST. EUS can also guide needle aspiration of these lesions to obtain diagnostic tissue. The discovery of mutations in a membrane transduction receptor, KIT, has led to greater understanding of the pathogenesis of this tumor and has even provided clues to its cell of origin. Moreover, a unique therapeutic agent, imatinib, has been devised that specifically targets the aberrant KIT receptor and has demonstrated dramatic therapeutic efficacy in this otherwise resistant malignancy. Additional strides have been made in developing consensus definitions for GIST and for their laparoscopic resection.SummaryMajor advances in GIST diagnosis and treatment have occurred during the past several years and have improved the care of patients with all forms of this tumor.