胃と腸48巻10号

2013年09月発行

今月の主題 小腸の悪性腫瘍 主題

小腸悪性腫瘍の診断と治療―GIST

著者： 松田圭二¹ 塚本充雄¹ 福島慶久¹ 赤羽根拓弥¹ 島田竜¹ 堀内敦¹ 中村圭介¹ 端山軍¹ 山田英樹¹ 石原聡一郎¹ 野澤慶次郎¹ 橋口陽二郎¹

所属機関： ¹帝京大学医学部附属病院外科

ページ範囲：P.1446 - P.1460

要旨　小腸GISTの臨床病理学的特徴について，胃GISTとの比較を中心に述べた．小腸GISTは胃GISTと比較して，腫瘍径が大きく，術前生検採取が難しい．組織所見としては紡錘形が多く，遺伝子については，c-kit exon 9変異の頻度が高く，c-kit exon 11変異の頻度は低いという特徴がみられた．また，NF1の患者に合併しやすく，術後再発率が高く，予後不良であった．小腸GISTを術前に確定診断することは困難なことが多いため，CT，小腸内視鏡，小腸X線造影などの精査で小腸GISTの可能性が疑われたときは，安易に経過観察せずに外科治療を選択することが重要である．

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