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Introduction Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tissue-derived tumor of the digestive tract with multi-differentiation potential.
At present, it is generally believed that GIST originates from the pacemaker cell Cajar cells or Cajar stem cell precursors of the gastrointestinal tract, and is closely related to gene mutations such as tyrosine kinase receptor c-kit or platelet-derived growth factor receptor α.
GIST has a potential for malignant transformation, and its risk is closely related to tumor size, location, and mitosis.
GIST can occur in all parts of the digestive tract, of which the stomach is the most common, followed by the small intestine, rectum, colon and esophagus.
This article mainly introduces the common symptoms, risk factors, diagnosis and treatment of GIST.
Common symptoms of GIST The clinical symptoms of GIST are not specific and can vary depending on the size and location of the tumor.
Some GIST patients may present with gastrointestinal bleeding, perforation, abdominal mass, fever, night sweats, unexplained weight loss, stomach pain, dysphagia, and a small number of patients may also have constipation or gastrointestinal obstruction.
Risk factors for GIST There are few known risk factors for GIST.
The American Cancer Society (ACS) lists the following possible risk factors: Older GIST seems to be more common in people over 50.
Inheritance of certain syndromes In rare cases, certain inherited syndromes may cause some family members to develop GIST.
These syndromes include: Primary familial GIST syndrome: This is a rare disease caused by a child inheriting an abnormal KIT gene from a parent.
The disease can make patients more likely to develop GIST at a younger age.
Neurofibromatosis type 1: The cause of this disease is a defect in the NF1 gene.
Babies with this disease may have larger benign tumors and abnormal skin pigmentation.
Carney-Stratakis syndrome: This genetic disease is caused by a change in one of the succinate dehydrogenase (SDH) genes.
Studies have shown that possible risk factors for secondary or recurring GIST include: high mitotic count: mitotic count refers to the number of cells that divide in a certain amount of cancer tissue.
A high count usually indicates that the cancer has spread.
Non-gastric origin: If the origin is not in the stomach, but in another location in the gastrointestinal tract, the patient may be more likely to develop secondary GIST.
Certain genetic mutations: The researchers suggest that patients with mutations in the KIT exon 9 gene need to be carefully monitored for cancer recurrence.
Other factors (such as the size of the tumor and whether the primary tumor is ruptured) can put patients at a higher risk of recurrence of GIST.
The diagnosis method of GIST The diagnosis of GIST mainly depends on the results of histopathological examination and immunohistochemical examination.
At the initial consultation, the doctor may perform a physical examination of the patient to assess whether there is a mass in the abdomen or other gastrointestinal area.
If it is suspected that the patient has GIST, the patient can undergo imaging or endoscopy to confirm the diagnosis.
Although the above tests can visually assess whether there is a mass or tumor in the patient's gastrointestinal tract, in some cases, it may be necessary to perform a biopsy on the patient, remove the cells from the biopsy site and send them for testing.
Treatment of GIST The treatment of GIST is based on comprehensive treatment.
Surgical resection is the first choice.
Compared with traditional surgical resection, laparoscopy and endoscopy have developed rapidly in terms of surgical procedures and complications.
At the same time, minimally invasive surgery The application of GIST treatment is also more extensive.
However, there are reports in the literature that about 50% of GIST patients will have recurrence or metastasis after surgery.
The emergence of molecularly targeted drug tyrosine kinase inhibitors brings new hope to patients with advanced, recurring, metastatic, or intermediate-to-high-risk GIST.
Surgical treatment: If feasible, the first choice for GIST treatment should be surgery to completely remove the cancerous tissue.
Neoadjuvant therapy: If surgery is not possible initially, the patient may need neoadjuvant therapy to shrink the tumor.
Such as chemotherapy, radiation therapy and hormone therapy.
Tyrosine kinase inhibitor (TKI): This is a chemotherapeutic drug that blocks tyrosine kinase.
Tyrosine kinases send growth signals to cells, and by inhibiting them, TKI can prevent cancer cells from growing and multiplying.
Other types of drugs: Patients can receive other types of cancer treatment drugs, such as sunitinib and regorafenib.
References: [1] Li Longquan, Wang Yongqing, Ma Ming, et al.
Progress in the treatment of gastrointestinal stromal tumors[J].
Medical Review, 2021, 27(08):1539-1544.
[2] Brown LM.
What to know about gastrointestinal stromal tumors.
MEDICAL NEWS TODAY.
2020 Oct 5.
Contribution email: tougao@medlive.
cn
At present, it is generally believed that GIST originates from the pacemaker cell Cajar cells or Cajar stem cell precursors of the gastrointestinal tract, and is closely related to gene mutations such as tyrosine kinase receptor c-kit or platelet-derived growth factor receptor α.
GIST has a potential for malignant transformation, and its risk is closely related to tumor size, location, and mitosis.
GIST can occur in all parts of the digestive tract, of which the stomach is the most common, followed by the small intestine, rectum, colon and esophagus.
This article mainly introduces the common symptoms, risk factors, diagnosis and treatment of GIST.
Common symptoms of GIST The clinical symptoms of GIST are not specific and can vary depending on the size and location of the tumor.
Some GIST patients may present with gastrointestinal bleeding, perforation, abdominal mass, fever, night sweats, unexplained weight loss, stomach pain, dysphagia, and a small number of patients may also have constipation or gastrointestinal obstruction.
Risk factors for GIST There are few known risk factors for GIST.
The American Cancer Society (ACS) lists the following possible risk factors: Older GIST seems to be more common in people over 50.
Inheritance of certain syndromes In rare cases, certain inherited syndromes may cause some family members to develop GIST.
These syndromes include: Primary familial GIST syndrome: This is a rare disease caused by a child inheriting an abnormal KIT gene from a parent.
The disease can make patients more likely to develop GIST at a younger age.
Neurofibromatosis type 1: The cause of this disease is a defect in the NF1 gene.
Babies with this disease may have larger benign tumors and abnormal skin pigmentation.
Carney-Stratakis syndrome: This genetic disease is caused by a change in one of the succinate dehydrogenase (SDH) genes.
Studies have shown that possible risk factors for secondary or recurring GIST include: high mitotic count: mitotic count refers to the number of cells that divide in a certain amount of cancer tissue.
A high count usually indicates that the cancer has spread.
Non-gastric origin: If the origin is not in the stomach, but in another location in the gastrointestinal tract, the patient may be more likely to develop secondary GIST.
Certain genetic mutations: The researchers suggest that patients with mutations in the KIT exon 9 gene need to be carefully monitored for cancer recurrence.
Other factors (such as the size of the tumor and whether the primary tumor is ruptured) can put patients at a higher risk of recurrence of GIST.
The diagnosis method of GIST The diagnosis of GIST mainly depends on the results of histopathological examination and immunohistochemical examination.
At the initial consultation, the doctor may perform a physical examination of the patient to assess whether there is a mass in the abdomen or other gastrointestinal area.
If it is suspected that the patient has GIST, the patient can undergo imaging or endoscopy to confirm the diagnosis.
Although the above tests can visually assess whether there is a mass or tumor in the patient's gastrointestinal tract, in some cases, it may be necessary to perform a biopsy on the patient, remove the cells from the biopsy site and send them for testing.
Treatment of GIST The treatment of GIST is based on comprehensive treatment.
Surgical resection is the first choice.
Compared with traditional surgical resection, laparoscopy and endoscopy have developed rapidly in terms of surgical procedures and complications.
At the same time, minimally invasive surgery The application of GIST treatment is also more extensive.
However, there are reports in the literature that about 50% of GIST patients will have recurrence or metastasis after surgery.
The emergence of molecularly targeted drug tyrosine kinase inhibitors brings new hope to patients with advanced, recurring, metastatic, or intermediate-to-high-risk GIST.
Surgical treatment: If feasible, the first choice for GIST treatment should be surgery to completely remove the cancerous tissue.
Neoadjuvant therapy: If surgery is not possible initially, the patient may need neoadjuvant therapy to shrink the tumor.
Such as chemotherapy, radiation therapy and hormone therapy.
Tyrosine kinase inhibitor (TKI): This is a chemotherapeutic drug that blocks tyrosine kinase.
Tyrosine kinases send growth signals to cells, and by inhibiting them, TKI can prevent cancer cells from growing and multiplying.
Other types of drugs: Patients can receive other types of cancer treatment drugs, such as sunitinib and regorafenib.
References: [1] Li Longquan, Wang Yongqing, Ma Ming, et al.
Progress in the treatment of gastrointestinal stromal tumors[J].
Medical Review, 2021, 27(08):1539-1544.
[2] Brown LM.
What to know about gastrointestinal stromal tumors.
MEDICAL NEWS TODAY.
2020 Oct 5.
Contribution email: tougao@medlive.
cn
