在新辅助治疗后食道胃肠道筋瘤的内镜切除:最小侵入性治疗的新范式?
Fabian Dario Rodriguez-Monaco1, Maximilian Herter1, Dolores Krauss2
1Department of Medicine/Gastroenterology, Gemeinschaftskrankenhaus Bonn, Bonn, Germany.
ACG case reports journal
|November 26, 2025
概括
新辅助性意马替尼治疗成功缩小了大食道胃肠道 stromal 瘤 (eGIST),使其能够进行内镜切除. 这种方法可能会增加罕见的eGISTs的切除能力.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 医学瘤学 医学瘤学
背景情况:
- 消化管胃肠道 stromal 瘤 (eGISTs) 是一种罕见的介质细胞瘤.
- 目前的治疗指南强调局部GISTs的完全手术切除 (R0).
- 大型eGIST对完全内镜去除提出了挑战.
研究的目的:
- 评估新辅助性意马替尼治疗在缩小大型eGIST的疗效.
- 评估新辅助治疗后内镜道切除的可行性.
- 报告使用这种策略治疗的患者的长期结果.
主要方法:
- 一名患有>30毫米局部中食管GIST的患者接受了新辅助剂伊马替尼布400毫克.
- 评估了瘤反应,随后进行了内镜道切除.
- 组织病理学分析证实了瘤特征和切除边缘.
- 手术后的治疗包括继续治疗伊马替尼.
主要成果:
- 新辅助剂意马替尼有效地缩小了eGIST的规模.
- 瘤成功地通过内镜切除,没有并发症.
- 组织病理学揭示了一个ypT1-R1 eGIST,尺寸为19 × 18 × 17毫米.
- 患者在切割后1年与持续的伊马替尼治疗中实现了缓解.
结论:
- 新辅助性意马替尼治疗可以促进大型eGIST的内镜切除.
- 这一策略可能会扩大对eGIST管理的最小侵入性技术的适用性.
- 共享决策和量身定制的治疗对于最佳的患者结果至关重要.
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