论文部分内容阅读
近年来,胃肠间质瘤(GIST)在活检时机选择、分子标志物、基因突变分析、预后因素(肿瘤危险分级)、靶向治疗效果评估方法、腹腔镜手术进展、进展期患者术前药物治疗及手术时机选择、靶向治疗耐药机制及应对策略等热点问题达成诸多共识。活检、分子标志物、基因突变分析对GIST早期诊断及指导治疗具有重要意义。进展期患者应早期行术前评估,并且进行危险分级,对手术风险较大患者可先进行术前治疗,并早期进行疗效评价,对于肿瘤降级后可行手术切除者尽早手术切除,而对于靶向治疗无反应的患者,应尽早行基因分析,并根据不同耐药机制采取不同应对策略。
In recent years, gastrointestinal stromal tumors (GIST) in the timing of biopsy, molecular markers, gene mutation analysis, prognostic factors (tumor risk grading), evaluation of targeted therapies, laparoscopic surgery, advanced patients with preoperative drugs Treatment and timing of surgery, targeted drug resistance mechanisms and coping strategies and other hot issues reached a lot of consensus. Biopsy, molecular markers, gene mutation analysis of GIST early diagnosis and treatment is of great significance. Patients with advanced disease should be preoperatively evaluated and risk stratified. Patients with high surgical risk may undergo preoperative treatment and early evaluation of the effect, as soon as possible for operable resection after tumor degradation, while for targeted In patients with no response, gene analysis should be performed as soon as possible and different coping strategies should be taken based on different drug resistance mechanisms.