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Pathologie und Molekularbiologie gastrointestinaler Stromatumoren (GIST)

Pathology and molecular biology of gastrointestinal stromal tumors (GIST)

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Zusammenfassung

Gastrointestinale Stromatumoren (GIST) zeigen in etwa 50% der Fälle einen aggressiven Phänotyp mit Rezidiven und Metastasen. Sie können immunhistochemisch sicher von anderen mesenchymalen Tumorentitäten unterschieden werden und tragen in bis zu 85% der Fälle aktivierende Mutationen in den Rezeptortyrosinkinasen KIT oder PDGFRA. Die Aufklärung ihrer molekularen Pathogenese hatte einen therapeutischen Paradigmenwechsel zur Folge. Bei inoperablen oder metastasierten GIST stellt die Behandlung mit Tyrosinkinaseinhibitoren heute den Goldstandard dar mit einer Ansprechrate von bis zu 80% bei vergleichsweise geringen Nebenwirkungen. Die Kenntnis der KIT- bzw. PDGFRA-Mutation ist dabei sowohl prognostisch als auch therapeutisch von zentraler Bedeutung.

Abstract

Gastrointestinal stromal tumors (GIST) show an aggressive behavior with metastases and recurrences in up to 50% of cases. They can be clearly distinguished from other mesenchymal tumors by immunohistochemistry in the vast majority of cases. Of the tumors 85% carry somatic activating mutations in the receptor tyrosine kinases KIT or PDGFRA. The detection of these molecular events has changed the treatment of inoperable and metastatic GISTs dramatically as up to 80% of tumors respond well to tyrosine kinase inhibitors. This treatment has become the gold standard in the last few years with only few side effects. Knowledge of the underlying KIT or PDGFRA mutation is both relevant for the prognosis and treatment response.

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Interessenkonflikt

Prof. Dr. Eva Wardelmann erhält Vortragshonorare und Studienunterstützung von der Firma Novartis.

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Authors and Affiliations

  1. Institut für Pathologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland

    H.-U. Schildhaus, S. Merkelbach-Bruse, R. Büttner &  E. Wardelmann

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  1. H.-U. Schildhaus
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  2. S. Merkelbach-Bruse
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  3. R. Büttner
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  4. E. Wardelmann
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Correspondence to E. Wardelmann.

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Schildhaus, HU., Merkelbach-Bruse, S., Büttner, R. et al. Pathologie und Molekularbiologie gastrointestinaler Stromatumoren (GIST). Radiologe 49, 1104–1108 (2009). https://doi.org/10.1007/s00117-009-1850-y

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  • DOI: https://doi.org/10.1007/s00117-009-1850-y

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