Abstract:

Treatment controversy and strategies of gastric and rectal small gastrointestinal stromal tumor   DAI Dong-qiu, ZHANG Cheng, ZHANG Chun-dong. Department of Gastrointestinal Surgery, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China
Corresponding author: DAI Dong-qiu, E-mail: daidq63@163.com
Abstract    In recent years, as the study has progressed gradually and the diagnostic methods has been improved, the diagnosis of patients with gastrointestinal stromal tumor (GIST) has been continuously increasing year by year clinically. Most patients with GIST have no obvious specific symptoms. Particularly, small GIST patients with a diameter of less than 2 cm are devoid of specific clinical manifestations and might be diagnosed occasionally. The combinations of imaging and pathology examination should be applied to the diagnosis of small GIST, and gene testing should be applied when necessary. At present, the treatment strategy of small GIST is still controversial; thus, a comprehensive evaluation should be performed based on the location, size, metastasis, risk assessment, and clinical manifestation of small GIST. The optimal therapeutic strategy should be applied to ensure the surgical and oncological safety in the treatment of small GIST.

Key words: gastrointestinal stromal tumor, stomach, rectum, pathology, imaging, gene mutation, laparoscope, endoscope

摘要：

近年来，随着对胃肠间质瘤 （GIST）的研究逐渐深入以及检查手段的不断完善，临床上确诊为GIST的病人逐年增多。大部分GIST病人无明显特异症状，尤其直径<2 cm的小GIST更加缺少特异性临床表现，多为偶然发现。对于小GIST的诊断须影像学和病理学检查相配合，必要时行基因检测。目前关于胃及直肠小GIST的治疗尚存在争议，应根据小GIST病变的位置、大小、是否转移与危险度，以及病人临床表现进行综合评估，采取最佳治疗策略，以保证小GIST治疗的安全性及根治性。

关键词: 胃肠间质瘤, 胃, 直肠, 病理学, 影像学, 基因突变, 腹腔镜, 内镜