Onkologie. 2014:8(6):249-256

Diagnosis of gastrointestinal stromal tumors

Vincent Zoundjiekpon¹, Ondřej Urban^1,2,3, Martin Rydlo², Dušan Žiak^4,5, Přemysl Falt¹, Eva Kundrátová¹, Martin Hanousek¹, Petr Fojtík¹, Otto Mikolajek¹

¹ Vzdělávací a výzkumný institut AGEL, pracoviště Centrum péče o zažívací trakt, Vítkovická nemocnice a.s., Ostrava

² Interní klinika, Fakultní nemocnice Ostrava

³ Lékařská fakulta, Ostravská univerzita, Ostrava

⁴ Ústav patologie, Fakultní nemocnice Ostrava

⁵ Vzdělávací a výzkumný institut AGEL, pracoviště CGB laboratoř a.s., Ostrava

Gastrointestinal stromal tumours (GIST) are the most common gastrointestinal mesenchymal tumours, almost always with malignant potential.

GIST arise almost always from precursor cells of Cajal, often presenting mutations in the genes KIT or PDGFRA. For a long time were GIST misdiagnosed

and mistaken for leiomyoma, leiomyosarcoma, leiomyoblastoma or schwannoma. Nowadays represent GIST an independant unit of

submucosal tumours, and their diagnosis is more and more precise because of the development of immunohistochemistry and the discovery

of tyrosine kinase receptors. However it is difficult to estimate exactly their incidence. Clinical feature of GIST patients depends mainly on their

location, size and the presence of metastases. Treatement and prognosis of GIST depend on their diagnosis due to morphological, endoscopical,

histological, immunohistochemical exmination and to molecular-genetical analysis. Radiological examinations have still their place in the diagnostic

and surveillance of GIST. Management of GIST (from diagnosis to treatement) is cross-sectoral issue. Despite the rapid development and

significant progress of the biological treatment by inhibitors of tyrosine kinase receptors, radical surgical resection of GIST remains the primary

and most effective treatment for GIST, especially those with little malignant potential or symptomatics. Treatment with imatinib or sunitinib is

reserved for patients with CD117 positive unresectable and/or metastatic malignant GIST. Adjuvant treatment with imatinib is an integral part

of the successful biological treatments for some well-chosen gastrointestinal stromal tumors. In the case of tumor progression during treatment

with imatinib and sunitinib, there is the opportunity to submit new tyrosine kinase inhibitors.

treatment, tyrosinkinase inhibitors, Imatinib, Sunitinib.

Keywords: gastrointestinal stromal tumours, precursor cells of Cajal, KIT (CD117), PDGFRA, management, surgical treatment, biological

Published: December 15, 2014  Show citation