Gastrointestinal stromal tumours.

摘要: Gastrointestinal stromal tumour (GIST) is the designation used here to identify most common subset of gastrointestinal mesenchymal tumours specific those sites. These have unique histological, immunophenotypic and molecular genetic features that set them apart from typical smooth muscle schwannomas; however, by tradition, they been classified as GI-smooth tumours, or tumours/smooth tumours. GISTs occur predominantly in persons over 40 years age with an equal sex incidence. Benign outnumber malignant ones a margin 10:1. throughout tract, but are stomach (60-70%) small intestine (30%). rare esophagus, colon rectum. Histologically may show spindle cell epithelioid pattern (the former largely corresponds cellular leiomyoma latter leiomyoblastoma). Immunohistochemically positive for CD34 c-kit protein (CD117); quite among Genetically commonly DNA losses long arm chromosome 14, gene mutations at least some cases. also expressed interstitial cells Cajal, pacemaker cells, relationship these has proposed recently. differ histologically, immunohistochemically genetically (esophageal) leiomyomas negative neither DNA-losses 14q nor mutations. Evaluation malignancy based on mitotic count, size extra-gastrointestinal spread. Tumours counts higher than 5/10 high power fields larger 10 cm significant risk recurrence metastasis considered histologically malignant; activity < 1/10HPF metastasize indicating uncertainty potential GISTs, especially 5 cm.