[在NAC-Imatinib-A病例报告后胃肠胃瘤的表型变化]
Junki Yamada1, Kei Sato, Selen Tomita
1Dept. of Surgery, Yokohama City Minato Red Cross Hospital.
Gan to kagaku ryoho. Cancer & chemotherapy
|February 26, 2026
概括
这项案例研究强调了新辅助化疗 (NAC) 后胃肠道 stromal 瘤 (GIST) 的诊断挑战. 后NAC组织病理学显著改变了发现,影响了准确的诊断.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 病理学 病理学 病理学
背景情况:
- 胃肠道 stromal 瘤 (GIST) 是胃肠道中瘤最常见的一种.
- 新辅助化疗 (NAC) 越来越多地用于GIST管理,但其对其组织病理特征的影响尚未完全理解.
- 准确的GIST诊断依赖于特征性的组织病理学发现和免疫组织化学 (IHC) 染色.
研究的目的:
- 在NAC.之后报告一个具有挑战性的GIST诊断案例.
- 审查NAC之后GIST中IHC变化的文献.
- 强调考虑治疗后遗传病学变化的重要性.
主要方法:
- 一个53岁的男性的病例介绍,他患有腹上疼痛和粘膜下瘤.
- 基于胃镜检查,活检和IHC (c-kit阳性) 的GIST初步诊断.
- 在NAC后进行手术切除,然后对切除的标本进行详细的病学分析.
主要成果:
- 最初的活检诊断出GIST具有状细胞增殖和c-kit阳性.
- 切除样本的NAC后组织病理学发现与活检显著不同.
- 完成了完整的切除,但术后诊断因改变的组织学而复杂化.
结论:
- 新辅助化疗可以显著改变GIST的组织病理学,这给诊断带来了挑战.
- 在NAC之后,GIST中IHC变化的文献很少.
- 这一案例强调了需要仔细解释后NAC标本和进一步研究治疗诱导的组织学修饰的必要性.
相关概念视频
01:23Gastritis III: Clinical Manifestations and Management
1.4K
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
1.4K
01:27Gastritis-I: Introduction and Types
2.7K
Gastritis, defined by the inflammation or irritation of the stomach lining or gastric mucosa, manifests in several distinct forms: acute, chronic, reactive, and a specific subtype known as autoimmune metaplastic atrophic gastritis.
Acute gastritis presents as a sudden inflammation triggered by various stressors to the stomach lining, such as exposure to corrosive agents, local irritants like aspirin and other NSAIDs, alcohol consumption, radiation therapy, physical trauma, severe burns, sepsis,...
Acute gastritis presents as a sudden inflammation triggered by various stressors to the stomach lining, such as exposure to corrosive agents, local irritants like aspirin and other NSAIDs, alcohol consumption, radiation therapy, physical trauma, severe burns, sepsis,...
2.7K
01:17Gastritis-II: Pathophysiology
1.5K
Gastritis is marked by disruption of the mucosal barrier that usually protects the stomach tissue from digestive juices and manifests in acute and chronic forms.
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
1.5K
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
691
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
691
01:21Barrett Esophagus-II: Clinical Manifestations and Management
1.3K
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
1.3K
01:16Gastric Motility
3.6K
Gastric motility is the coordinated contraction and relaxation of stomach muscles that convert ingested food into chyme, a semi-liquid substance ready for further digestion in the intestines. The process begins with the vagus nerve inducing the relaxation of the smooth muscles in the fundus and body of the stomach, allowing these regions to expand and accommodate up to approximately 1.5 liters of food and liquid.
Peristaltic Waves and Chyme Formation
Upon food entry, the stomach initiates...
Peristaltic Waves and Chyme Formation
Upon food entry, the stomach initiates...
3.6K