摘要
胃腸道間質瘤過去被認為源自於肌肉細胞，是腸胃道腫瘤中較罕見且獨特的腫瘤。雖然到目前為止，它確切的細胞來源仍未確立，最近的研究顯示interstitial cells of Cajal (ICCs)是很可能的來源。而c-kit proto-oncogen (CD 117)的發現更開啓了胃腸道間質瘤診斷與治療新的契機。我們報告一例八十歲婦人罹患胃間質瘤。她的起始症狀為腹部可摸到腫塊，超音波顯示其左上腹有一巨大高回音腫瘤，中心有與回音至低回音之區域。接下來的胃鏡檢查顯示胃體部有一疑似黏膜下腫瘤，中心點有潰瘍合併輕微滲血。電腦斷層所見與超音波類似並懷疑有胰臟侵犯。患者最後接受開刀移除腫瘤，病理報告證明為胃腸道間質瘤。CD 117呈陽性反應並有高細胞分裂指數。我們並且簡短的回顧目前文獻上c-kit proto-oncogen(CD 117)與胃腸道間質瘤的關聯，以及其與治療及診斷之相關關係。
並列摘要
Gastrointestinal stromal tumors (GISTs), previously thought to be smooth muscle neoplasms, represent an unique disease entity among gastrointestinal tumors. Although the real cellular origin of GIST is still unclear recent study suggested that interstitial cells of Cajal (ICCs) may represent a possible histogenetic origin. With the recovery of c-kit proto-oncogen over chromosome 4q, its encoded protein CD 117 had opened a new era for the diagnosis and treatment of GIST. We reported a 80-year-old lady suffering from stomach GIST with an initial symptom of palpable abdominal mass. Abdominal sonographic examination showed a huge hyperechoic tumor with central echo-lucency over her left abdomen. Subsequent upper gastrointestinal panendoscopy revealed an ulcerated submucosal tumor of stomach with minimal bleeding. Abdomen computed tomography suggested similar finding with suspected pancreas invasion. She received laparotomy and the tumor was totally removed. Pathologic examination confirmed that the tumor was GIST with high mitotic index and had positive c-kit proto-oncogen (CD 117). We will discuss briefly the relationship, between CD 117 and GIST and its implication inpatient's management.
延伸閱讀
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