(新方向的管理先进、转移性胃肠道间质瘤(GIST):结合手术和系统性与伊马替尼治疗原发性胃位置的情况下)。

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卡塔尼亚M R·德·米利托,思米M

(新方向的管理先进、转移性胃肠道间质瘤(GIST):结合手术和系统性与伊马替尼治疗原发性胃位置的情况下)。

Chir斜体字。2005;1 - 2月57(1):127 - 33所示。

PubMed ID

15832750 (在PubMed

]

文摘

胃肠道间质肿瘤(要点)是罕见的肿瘤源自结缔组织在消化道的发生率低于1%,占大多数non-epithelial原始消化肿瘤。转移诊断时疾病的发现证实了要点恶性肿瘤。Kit蛋白,转移膜受体酪氨酸激酶的雄蕊的细胞,是典型的表达的要点。大多数要点都有原癌基因突变的工具包。抵抗常规化疗通常是恶性GIST所示。大多数晚期恶性GIST患者达到临床益处与伊马替尼甲磺酸盐,一个口头管理酪氨酸激酶受体的选择性抑制剂。我们对待一个43岁的男性病人患有胃手术紧急操作期间诊断要点为腹膜炎引起胃穿孔。第一次手术时病人失去了10公斤体重在前几个月和恶病的很严重。在紧急手术穿孔缝合。活检结果显示存在CD1 17 (c - kit)和CD34标记。 A total body CT scan documented the substantial size of the gastric wall lesion, an increased volume of abdominal lymph nodes and compression of the splenic vein with alternative collateral circulation. The liver presented no less than 5 large metastases distributed in both the left and right lobes. There was also a pulmonary metastasis. Because of frequent spontaneous bleeding and starvation the patient was seriously anaemic. Considering the action mechanism of imatinib and the extent of the lesion we decided to perform a total gastrectomy procedure. At the time of the operation the stomach seemed to have a modified volume and shape: it appeared to be divided into two sacs, the larger and deeper of which was the original gastric cavity, while the superficial, smaller one seemed to be a protrusion of the organ. The stomach was indistinguishable from the spleen, the transverse colon and the distal pancreatic tract. The neoplasm was directly linked to the left liver and to the inferior diaphragmatic surface. We performed total gastrectomy and resection of the tail of the pancreas, the spleen, and the transverse colon all in one and the same session. The patient was discharged on postoperative day 8 and commenced imatinib therapy 30 days after the operation with 4 tablets per day. In the following months the patient repeated the CT scan to monitor the progressive volume reduction of the liver and lung lesions and a PET scan confirmed that the lesions were not active; the patient experienced a 13 kg body weight increase. One year after the operation the outcome appears to be lasting and the patient has tolerated the drug treatment well.

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药物靶点

药物	目标	类	生物	药理作用	行动
伊马替尼	神经生长因子受体高亲和力	蛋白质	人类	未知的	拮抗剂	细节