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Diagnostik und Therapie von gastrointestinalen Stromatumoren (GIST)

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Weiterbildung Onkologie

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Zusammenfassung

GIST sind mesenchymale Tumoren, deren Ursprung in den interstitiellen Cajal-Zellen vermutet wird. Charakteristisch ist eine CD117-Expression, die auf einer aktivierenden Mutation des Tyrosinkinaserezeptors basiert, die zu einem unkontrollierten Proliferationsreiz und dem Verlust der Apoptosefunktion mit konsekutivem Tumorwachstum führt. Einige GIST sind CD117-negativ und weisen eine Mutation des PDGFRA-Gens („platelet derived growth factor receptor α“) auf. Die Bestimmung des c-KIT - bzw. PDGFRA-Status ist deshalb für die Diagnosestellung obligat. Klinisch gibt es 3 entscheidende Prognosefaktoren: Tumorgröße, -lokalisation und -mitoserate. Goldstandard für lokalisierte, resezierbare GIST ist die komplette chirurgische Resektion. In Abhängigkeit vom Rezidivrisiko erfolgt eine Therapie mit Imatinib (adjuvant 400 mg über 3 Jahre). Auch bei lokal fortgeschrittenen, inoperablen oder metastasierten GIST ist Imatinib je nach Mutationsstatus aktuelle Standardtherapie.

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Author information

Authors and Affiliations

  1. Abteilung für Hämatologie und Onkologie, Medizinische Klinik I, Katholisches Klinikum Bochum gGmbH, Ruhr-Universität Bochum, Gudrunstraße 56, 44791, Bochum, Deutschland

    Dr. N. Höffken & A. Reinacher-Schick

  2. Institut für Pathologie, Ruhr-Universität Bochum, Bochum, Deutschland

    A. Tannapfel

Authors
  1. Dr. N. Höffken
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  2. A. Tannapfel
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  3. A. Reinacher-Schick
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Editor information

Editors and Affiliations

  1. Klinik für Strahlentherapie und Radio-Onkologie, Ruhr-Universität Bochum, Marienhospital Herne, Herne, Germany

    Irenäus A. Adamietz

  2. Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Frankfurt, Frankfurt, Germany

    Wolf O. Bechstein

  3. Klinik für Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover, Hannover, Germany

    Hans Christiansen

  4. Urologikum Lübeck, Lübeck, Germany

    Christian Doehn

  5. Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany

    Andreas Hochhaus

  6. TagesTherapieZentrum (TTZ), Universitätsmedizin Mannheim, Mannheim, Germany

    Ralf-Dieter Hofheinz

  7. Klinik für Gynäkologie, Charité - Universitätsmedizin Berlin, Berlin, Germany

    Werner Lichtenegger

  8. Klinik für Dermatologie, Universitätsklinikum Essen, Essen, Germany

    Dirk Schadendorf

  9. Klinik für Gynäkologie und Geburtshilfeum, HELIOS Klinikum Berlin-Buch, Berlin, Germany

    Michael Untch

  10. Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig, Germany

    Christian F. Wittekind

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Höffken, N., Tannapfel, A., Reinacher-Schick, A. (2015). Diagnostik und Therapie von gastrointestinalen Stromatumoren (GIST). In: Adamietz, I., et al. Weiterbildung Onkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44835-9_15

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  • DOI: https://doi.org/10.1007/978-3-662-44835-9_15

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  • Publisher Name: Springer, Berlin, Heidelberg

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  • Online ISBN: 978-3-662-44835-9

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