胃肠道间质瘤术后随访综述分析

摘要:

胃肠道间质瘤(gastrointestinal stromal tumor, GIST)是一类较为少见的胃肠道肿瘤,过去常被误认为平滑肌瘤、平滑肌肉瘤、神经鞘瘤或纤维组织细胞瘤,直到1983年Mazur和Clark才通过电镜观察和免疫组织化学检测结果提出了胃肠道间质瘤的概念。尽管少见,但是,GIST却是胃肠道最为常见的间叶源性肿瘤,约占间叶源性肿瘤的18%,每年发病率约为1~2/10万。其生物学特性与临床表现为潜在恶性。随着近年来对胃肠道间质瘤认识的不断发展以及治疗水平的不断提高,越来越多的GIST患者得到诊断,并且通过手术或是辅以口服分子靶向药物的方式来治疗胃肠道间质瘤,取得了很好的疗效。不论是传统的外科手术治疗还是腹腔镜治疗、内镜下治疗或是腹腔镜与内镜双镜联合治疗,这多种手术治疗方式都为大家所认可。但是,与这多种治疗方式不相匹配的是大家对于术后随访的重视程度。目前对于胃肠道间质瘤术后的随访,各国在各自指南中提出了不同要求,尚未达成统一共识。故现就各个国家和地区对胃肠道间质瘤的随访要求进行综述。

Abstract:

Gastrointestinal stromal tumor( GIST) is a rare gastrointestinal tumor, once was mistaken for leiomyoma, leiomyosarcoma, schwannolioma or fibrous histiocytoma in the past. The concept of gastrointestinal stromal tumor , not until 1983, was first proposed by observation via electron microscope and immuunohistochemistry by Mazur and Clark. GIST, although rare, is the most common mesenchymal tumor originated from gastrointestinal tract, account for 18% of all mesenchymal tumors, with an approximate annual incidence of 10 to 20 cases per 1 million. The biological characteristics and clinical manifestation of GIST has a potential for malignant transformation. With the growing awareness of gastrointestinal stromal tumor and the continuous improvement of medical level, more and more patients have been diagnosed and moreover, treated by operation and adjunctive molecular targeted therapy in the recent years. Not only traditional surgical treatment, but also laparoscopy treatment, endoscopy treatment, laparoscopic-endoscopic cooperative treatment have been accredited and have already achieved good results. However, follow-up of GIST after operation has not yet arouse enough attention, which leads to incomplete follow-up program. Countries made different demands in their respective guidelines, furthermore, a consensus has yet to be reached in the aspect of follow-up. Consequently, a review of follow-up of gastrointestinal stromal tumor is presented.