摘要
胃肠间质瘤(gastrointestinalstro-maltumor,GIST)是消化道最常见的间叶细胞瘤,与真性平滑肌瘤极为相似,在生物学行为上常难以判断,其临床表现又无特异性。因此,其诊断、鉴别诊断存在着较大困难。常规病理学检查很难预测GIST的预后,肿瘤大小、有丝分裂率以及其他的一些次要因素均影响其预后。GIST对放疗、化疗均不敏感,主要依赖于手术治疗,良性GIST预后极好,手术的5年生存率超过90%。然而复发者或恶性者即使手术其预后也极差。而STI571(imatinibmesylate,STI571)的出现给GIST的治疗带来了革命性的变化,成为公认的治疗不可切除的、转移或复发的GIST一线治疗药物,STI571的问世使得肿瘤治疗进入了分子靶向时代。但STI571是迄今为止惟一用于治疗的酪氨酸激酶抑制剂。由于临床使用时间不长,病例数有限,其确切疗效、毒副反应尚待进一步观察,此外用药时间、剂量范围仍需进一步研究。
Gastrointestinal stromal tumour （GIST） are the most common mesenchymal tumour of the digestive tract. GIST resemble leiomyomas extremely and their clinical characteristics and outcomes manifest differently. It is difficult to diagnose GIST at the basis of biologic behavior. At present, it is very difficult to diagnose and differentiate GIST. The biologic tumor size, mitotic rate and other minor factors have been identified as GIST prognostic indicators. GIST are resistant to radiotherapy and chemotherapy, surgery is the standard treatment for primary resectable GIST. Benign GIST（s） have an excellent prognosis after the primary surgical treatment, with over 90% 5-year survival, whihe recurrent or malignant GIST has until recently an extremely poor prognosis even after the surgical resection. STI571 brings a novel mode in the treatment of GIST and serves as the preferred drug for unresectable and metastatic and recurrent GIST. STI571 produces a targeted molecular therapeutic anticancer age in patients with GIST and it is the exclusive tyrosine kinase inhibitor in treatment of GIST. Because of the lack of clinical use and finite patients, the potential antitumour effect and adverse effects of imatinib in the treatment patients with GIST have yet to be defined. Further studies investigating the duration and optimal dose of imatinib are warranted.
出处
《中华肿瘤防治杂志》
CAS
2006年第20期1591-1594,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
胃肠道间质肿瘤/诊断
胃肠肿瘤/治疗
综述文献
gastrointestinal stromal tumors/diagnosis
gastrointestinal neoplasms/therapy review literature
