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There are tumors in the digestive tract, often manifested as vomiting blood, and many patients will be misdiagnosed as ulcer bleeding; Almost all tumor properties are malignant; Surgery will be like cutting leeks, cutting them very long; Finally, targeted drugs also have drug resistance problems ... this is gastrointestinal stromal tumor.
According to medical professionals, its incidence rate is about 0-20 cases per million people/kloc-0 in the United States every year. Previously, this disease was considered as a rare disease, but with the continuous progress of diagnostic technology, the number of patients with gastrointestinal stromal tumors has increased significantly in recent years, and many hospitals have also set up special diagnosis and treatment centers for gastrointestinal stromal tumors to carry out targeted comprehensive treatment.
The incidence of gastrointestinal stromal tumors is increasing.
I went to the hospital for vomiting blood many times a week ago and vomited 700 ml every time. I thought it was gastrointestinal ulcer bleeding, but I didn't expect gastroscopy and capsule endoscopy to find obvious bleeding spots and varicose veins. Zhou successfully stopped the bleeding and was admitted to the hospital several times. Results A CT scan found a clue: a large tumor grew in the abdomen. After surgical resection, the pathological report was gastrointestinal stromal tumor, which was originally caused by tumor mucosal ulcer and massive bleeding.
Pan Zhizhong, director of colorectal surgery at Sun Yat-sen University Cancer Hospital, said that gastrointestinal stromal tumors are mesenchymal tumors originating from the gastrointestinal tract, omentum and mesentery, and the probability of suffering from gastrointestinal stromal tumors is roughly the same for men and women. The onset age is about 50-65 years old, and it is rare for children to suffer from this disease. Gastrointestinal stromal tumors most often occur in the stomach (60-70%), followed by small intestine (20-30%), colon and rectum only account for 5%, and occasionally occur in the omentum and mesentery of the abdomen. Small stromal tumors (2 cm or smaller) are usually asymptomatic and are usually found in physical examination, endoscopy or examination as an accompanying disease. With the enlargement of tumor, the common clinical symptoms are nausea, vomiting, abdominal pain, abdominal mass, melena and anemia. These symptoms are also nonspecific and can also be seen in other digestive tract diseases.
50% patients are prone to recurrence and metastasis.
Pan Zhizhong said that the diagnosis and treatment of gastrointestinal stromal tumors face three major problems: high misdiagnosis rate, easy recurrence and metastasis, and basically ineffective radiotherapy and chemotherapy. About 85% of gastrointestinal stromal tumors occur in the stomach and small intestine. Due to the limitation of diagnostic techniques, about 70% patients with gastrointestinal tumors were initially diagnosed as leiomyomas and other sarcomas, which made it impossible to treat them in time. The low diagnosis rate also makes the public seriously lack of understanding of the harm of this disease.
So far, surgery is still a radical treatment for gastrointestinal stromal tumors. It is understood that the malignant degree of gastrointestinal stromal tumors varies greatly among different patients, and the malignant degree of stromal tumors can be roughly divided into five grades: extremely low, low, medium, high and extremely high risk. Extremely low, low and medium risk gastrointestinal stromal tumors have a good prognosis, and it is not easy to recur and metastasize after surgical resection, while high and extremely high risk tumors are easy to recur and metastasize.
In fact, all gastrointestinal stromal tumors have the potential risk of recurrence. 50% patients will eventually relapse, and the recurrence site is usually confined to abdominal cavity or liver, and there will be no lung metastasis and bone metastasis in advanced patients. The overall 5-year survival rate is only 40-50%, more than 90% of high-risk patients will relapse, and the 5-year survival rate of high-risk patients after surgical resection is only 20%. For surgeons, "this tumor is like cutting leeks. It grows longer and stronger. Some patients even had many operations, and then they were removed and then removed. "
Radiochemotherapy and chemotherapy are basically ineffective.
"Because gastrointestinal stromal tumors are not sensitive to radiotherapy and chemotherapy, doctors had no choice but to operate in the past." Pan Zhizhong said, but the advent of molecular targeted drugs has made a breakthrough in the treatment of stromal tumors. Before the advent of targeted drugs, the 5-year survival rate of gastrointestinal stromal tumors was less than 50%. The overall survival time of patients with metastatic or recurrent gastrointestinal stromal tumors is 12- 19 months. At present, the preoperative treatment of targeted drugs is mainly reflected in reducing the focus through oral drugs, creating more favorable conditions for surgical eradication and avoiding unnecessary combined organ resection. In the adjuvant treatment after surgical resection, taking targeted drugs can delay recurrence.
He emphasized that immunohistochemical analysis and gene detection analysis of multi-target pathological specimens can better avoid the occurrence of targeted drug resistance, and patients can decide which targeted therapeutic drugs to take and how much to take according to the test results. This individualized treatment plan is the trend of gastrointestinal stromal tumors in the future. Under the guidance of experienced specialists, patients can spend less money and make fewer mistakes. Moreover, with the increase of patients with stromal tumors, targeted drugs for stromal tumors have also been included in medical insurance and china charity federation's aid projects, and most patients with stromal tumors can obtain satisfactory survival and quality of life.