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中华结直肠疾病电子杂志 ›› 2019, Vol. 08 ›› Issue (03) : 227 -230. doi: 10.3877/cma.j.issn.2095-3224.2019.03.003

所属专题: 文献

青年专家论坛

直肠胃肠间质瘤的临床病理特征和治疗
张信华1,()   
  1. 1. 中山大学附属第一医院胃肠外科中心
  • 收稿日期:2018-10-17 出版日期:2019-06-25
  • 通信作者: 张信华
  • 基金资助:
    广东省科技计划(No.2016A020213002)

Pathoclinical characteristic and treatment of rectal gastrointestinal stromal tumors (GISTs)

Xinhua Zhang1,()   

  1. 1. Department of Gastrointinal Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
  • Received:2018-10-17 Published:2019-06-25
  • Corresponding author: Xinhua Zhang
  • About author:
    Corresponding author: Zhang Xinhua, Email:
引用本文:

张信华. 直肠胃肠间质瘤的临床病理特征和治疗[J]. 中华结直肠疾病电子杂志, 2019, 08(03): 227-230.

Xinhua Zhang. Pathoclinical characteristic and treatment of rectal gastrointestinal stromal tumors (GISTs)[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2019, 08(03): 227-230.

直肠是胃肠间质瘤的第三常见部位,其临床病理学特征、生物学行为和解剖部位使其诊治具有特殊性。好发于直肠中下段且术后局部复发率偏高,都是直肠GIST治疗的难点。伊马替尼的围手术期治疗增加了手术切除率并降低了复发率,5 cm以下的直肠GIST靶向治疗联合手术切除治疗效果较好。目前,国内外尚缺少直肠GIST的诊疗规范,未来还需要更多的前瞻性多中心研究进一步探讨并得出结论。

Rectum is the third most common site GISTs originise from. The management of rectal GISTs holds characteristics and difficulty owing to biology and anatomical location. They tending to occur in lower rectum with relatively high local recurrence rate. The application of peri-operational imatinib increase the resectability of tumor and lower recurrence rate. For rectal GIST with diameter of less than 5 cm, imatinib combined surgical resection can achieve a good therapeutic effect. At present, there is still lack of standard of diagnosis and treatment for rectal GIST worldwide. More prospective multicenter studies are needed for better understanding and management of this special entity.

[1]
Ducimetière F, Lurkin A, Ranchère-Vince D, et al. Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing [J]. PLoS One, 2011, 6(8): e20294.
[2]
Ma GL, Murphy JD, Martinez ME, et al. Epidemiology of gastrointestinal stromal tumors in the era of histology codes: results of a population-based study [J]. Cancer Epidemiol Biomarkers Prev, 2015, 24(1): 298-302.
[3]
Kukar M, Kapil A, Papenfuss W, et al. Gastrointestinal stromal tumors (GISTs) at uncommon locations: a large population based analysis [J]. J Surg Oncol, 2015, 111(6): 696-701.
[4]
Yasui M, Tsujinaka T, Mori M, et al. Characteristics and prognosis of rectal gastrointestinal stromal tumors: an analysis of registry data [J]. Surg Today, 2017, 47(10): 1188-1194.
[5]
Changchien CR, Wu MC, Tasi WS, et al. Evaluation of prognosis for malignant rectal gastrointestinal stromal tumor by clinical parameters and immmunohistochemical stanning [J]. Dis Colon Rctum, 2004, 47(11): 1922-1929.
[6]
Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites [J]. Semin Diagn Pathol, 2006, 23(2): 70-83.
[7]
Miettinen M, Lasota J. KIT (CD117): a review on expression in normal and neoplastic tissues, and mutations and their clinicopathologic correlation [J]. Appl Immunohistochem Mol Morphol, 2005, 13(3): 205-220.
[8]
Hawkins A, Wells K, Krishnamurty D, et al. Preoperative Chemotherapy and Survival for Large Anorectal Gastrointestinal Stromal Tumors: A National Analysis of 333 Cases [J]. Ann Surg Oncol, 2017, 24(5): 1195-1201.
[9]
Cavnar, M, Wang L, Balachandran V, et al. Rectal Gastrointestinal Stromal Tumor (GIST) in the era of imatinib: Organ preservation and improved oncologic O\outcome [J]. Ann Surg Oncol, 2017, 24(13): 3972-3980.
[10]
Corless CL, Fletcher JA, Heinrich MC. Biology of gastrointestinal stromal tumors [J]. J Clin Oncol, 2004, 22(18): 3813-3825.
[11]
Joensuu H, Vehtari A, Riihimaki J, et al. Risk of recurrence of gastrointestinal stromal tumour after surgery: an analysis of pooled population-based cohorts [J]. Lancet Oncol, 2012, 13(3): 265-274.
[12]
周维霞, 丁科枫,殷国建, 等. 超声内镜对结直肠黏膜下病变的诊断价值[J]. 中国内镜杂志, 2017, 23(6): 92-97.
[13]
Li J, Ye Y, Wang J, et al. Chinese consensus guidelines for diagnosis and management of gastrointestinal stromal tumor [J]. Chin J Cancer Res, 2017, 29(4): 281-293.
[14]
DeMatteo RP, Ballman KV, Antonescu CR, et al. Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial [J]. Lancet, 2009, 373(9669): 1097-1104.
[15]
Joensuu H, Eriksson M, Sundby Hall K, et al. One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor: a randomized trial [J]. JAMA, 2012, 307(12): 1265-1272.
[16]
Li J, Gong JF, Wu AW, et al. Post-operative imatinib in patients with intermediate or high risk gastrointestinal stromal tumor [J]. Eur J Surg Oncol, 2011, 37(4): 319-324.
[17]
Huynh TK, Meeus P, Cassier P, et al. Primary localized rectal/pararectal gastrointestinal stromal tumors: results of surgical and multimodal therapy from the French Sarcoma Group[J]. BMC Cancer, 2014, 14: 156.
[18]
Liu H, Yan Z, Liao G, et al. Treatment strategy of rectal gastrointestinal stromal tumor (GIST) [J]. J Surg Oncol, 2014, 109(7): 708-713.
[19]
Wilkinson MJ, Fitzgerald JE, Strauss DC, et al. Surgical treatment of gastrointestinal stromal tumour of the rectum in the era of imatinib [J]. Br J Surg, 2015, 102(8): 965-971.
[20]
Jakob J, Mussi C, Ronellenfitsch U, et al. Gastrointestinal stromal tumor of the rectum: results of surgical and multimodality therapy in the era of imatinib [J]. Ann Surg Oncol, 2013, 20(2): 586-592.
[21]
Pai VD, Demenezes JL, Patil PS, et al. Multimodality therapy of rectal gastrointestinal stromal tumors in the era of imatinib: an Indian series [J]. J Gastrointest Oncol, 2016, 7(2): 262-268.
[22]
Tielen R, Verhoef C, van Coevorden F, et al. Surgical management of rectal gastrointestinal stromal tumors [J]. J Surg Oncol, 2013, 107(4): 320-323.
[23]
中华医学会外科学分会胃肠外科学组. 胃肠间质瘤规范化外科治疗专家共识[J]. 中国实用外科杂志, 2015, 35(6): 593-597.
[24]
中华医学会外科学分会结直肠外科学组,中华医学会外科学分会腹腔镜与内镜外科学组. 直肠癌经肛全直肠系膜切除专家共识及手术操作指南(2017版) [J]. 中国实用外科杂志, 2017, 37(9): 978-984.
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