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대장에 발생한 위장관 간질성 종양의 특징

Gastrointestinal Stromal Tumors of the Colon and Rectum

대한대장항문학회지 2009년 25권 5호 p.318 ~ 322
백옥주 ( Paek Ok-Joo ) - 아주대학교 의과대학 외과학교실

오승엽 ( Oh Seung-Yeop ) - 아주대학교 의과대학 외과학교실
김영배 ( Kim Young-Bae ) - 아주대학교 의과대학 병리학교실

Abstract


Purpose: This study was designed to review the clinical characteristics of gastrointestinal stromal tumors (GISTs) of the colon and rectum and to evaluate their immunohistochemical and pathologic features based on the current National Institutes of Health criteria.

Methods: Patient and disease characteristics, pathologic features, surgical or endoscopic management, and clinical outcomes of 11 patients with GISTs diagnosed and primarily treated at our institution between March 1995 and February 2009 were evaluated.

Results: Colorectal GISTs accounted for 4.4% of all GISTs. The primary location was the rectum (8 cases). Four patients had high-risk GISTs, 4 patients had low-risk GISTs, and 3 patients had very low-risk GISTs. All tumors were c-kit positive. Four patients underwent a radical resection, whereas 7 patients underwent an endoscopic resection (n=3) or a transanal excision (n=4). Two high-risk patients without adjuvant Imatinib mesylate therapy developed metastases, but the other highrisk patients with adjuvant Imatinib mesylate therapy didn’t.

Conclusion: Colorectal GISTs occurred predominantly in the rectum. Because GISTs do not metastasize through the lymphatics, small GISTs that are amenable to local excision or endoscopic resection can be treated by either of these techniques as long as negative microscopic margins are obtained around the primary tumor. Patients with high-risk GISTs should be considered for the use of Imatinib mesylate as adjuvant therapy.

키워드

위장관 간질성 종양;점막하종양 ;C-kit
GIST (gastrointestinal stromal tumor);Submucosal tumor;C-kit
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