Chapter III/4: Clinical Aspects of GIST

Hagymási Krisztina

III/4.1: Introduction

Gastrointestinal stromal tumor (GIST) is the commonest mesenchymal neoplasm of the gastrointestinal tract. It accounts for 1 to 3% of all gastrointestinal tumors. Its origin has not been elucidated and the etiologic and risk factors are unknown. It probably starts from myenteric ganglial cells, Cajal cells or their precursors or from pluripotent CD34+ stem cells. An activating mutation of the KIT proto-oncogene is present in 90% of cases. C-kit protein, coded by the gene, is a transmembrane tyrosine kinase receptor that results in an uncontrolled stimulation of cell division and cell differentiation, causing proliferation of the cells. In 5% of cases a mutation and activation of platelet-derived growth factor receptor alpha (PDGF-α) is responsible for the development of the neoplasm, what may explain the c-kit protein negativity and primary imatinib-resistance of the tumor.

The chapter structure

• III/4.1: Introduction

• III/4.2: Epidemiology

• III/4.3: Course

• III/4.4: Symptomatology

• III/4.5: Diagnostics beyond imaging

• III/4.6: Therapy

References

Herszényi L.: A gyomor daganatai. Vékonybéldaganatok. In: A belgyógyászat alapjai (Szerk.: Tulassay Zs)., Medicina, 2011, Budapest, 1009-1018.

Az emésztőrendszer stromatumorainak (GIST) klinikai jelentősége. In: Gasztroenterológiai Útmutató (Szerk.: Tulassay Zs.), Klinikai Irányelvek Kézikönyve, Medition Kiadó, 2007, Budapest, 109-110.

Czakó L: Gasztrointestinális stromális tumorok. In: Gasztroenterológia, 2011, Medicina, Budapest, 278-280.

Cichoż-Lach, H., Kasztelan-Szczerbińska, B., Słomka, M.: Gastrointestinal stromal tumors: epidemiology, clinical picture, diagnosis, prognosis and treatment. Pol Arch Med Wewn 2008, 4: 216-221.

Stamatakos, M., Douzinas, E., Stefanaki, C. et al: Gastrointestinal stromal tumor. W J Surg Oncol 2009, 7: 61-69.