诊断

为了诊断 GIST，医务人员可能首先询问您的症状和健康状况。医务人员可能还会检查您的腹部是否有生长物。

如果症状表明您可能有 GIST，可能需要通过其他检查来找到肿瘤。这些检查可能包括：

  • 影像学检查。影像学检查可以帮助医护团队找到肿瘤和查看它的大小。检查可能包括超声波、CT、MRI 和正电子发射断层成像（PET）扫描。但并非每个患者都需要接受所有这些检查。
  • 上消化道内镜检查。这项检查使用一根末端有灯的细长管（内镜）。这根管通过口腔伸进咽喉。这项检查观察食管、胃部和小肠第一段的内膜。
  • 内镜超声（EUS）。这项检查也使用内镜，但内镜头端有超声探头。超声波探头利用声波生成肿瘤图像并显示它的大小。

  • 细针抽吸活检。这项检查采集少量肿瘤组织样本，以便在实验室进行检测。这项检查类似于 EUS，但内镜末端带有一根细空心针。EUS 寻找肿瘤。细空心针采集少量组织，以进行化验。

    有时，细空心针采集不到足够的细胞，或者结果不清晰。您可能需要通过手术来采集样本。

  • 活体组织的化验。医生会将肿瘤的活检样本送到实验室进行检测。在实验室中，专家会检测这些细胞，以了解它们是否是癌细胞。医务人员可以通过其他检查详细了解您的癌细胞，从而为您制定治疗计划。

治疗

GIST 通常需要通过手术和靶向疗法进行治疗。哪些治疗最适合取决于您的具体情况。

有些 GIST 不需要立即接受治疗。非常小、不会引起症状的 GIST 可能无需治疗。您可能只需要通过检查了解癌症是否生长。如果 GIST 生长，您可能需要开始治疗。

外科手术

这种手术的目标是完全切除 GIST。这通常是未扩散到身体其他部位的 GIST 的一线治疗方案。

如果您的肿瘤长得很大或者长到附近的结构中，可能无法进行手术。如果发生这种情况，一线治疗方案可能是通过靶向药物治疗来缩小肿瘤。您可以之后再接受手术。

手术的类型取决于您的癌症。外科医生一般通过微创手术来切除 GIST。这意味着手术工具通过腹部的小切口而不是大切口进入。

靶向药物治疗

靶向药物治疗专门针对癌细胞中存在的特定化学物质。通过阻断这些化学物质，靶向药物治疗可以杀死癌细胞。对于 GIST 来说，这些药物的靶点是一种叫做酪氨酸激酶的酶，这种酶有助于癌细胞生长。

GIST 的靶向药物治疗通常从伊马替尼（Gleevec）开始。下列情况下可进行靶向药物治疗：

  • 手术后降低癌症复发的风险
  • 手术前缩小肿瘤，使其更容易切除
  • 如果癌症已扩散到身体其他部位，则作为一线治疗方案
  • GIST 复发时

如果伊马替尼对您无效或不再有效，则可以使用其他靶向药物。靶向药物治疗是癌症研究的一个活跃领域，未来可能会出现新的可选药物。

准备您的预约

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you. If your health professional thinks that you might have a gastrointestinal stromal tumor, that person may refer you to a specialist. Often, this is a doctor who specializes in cancer, called a medical oncologist.

Appointments can be short and being prepared can help. Here's some information that may help you get ready.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test. Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for your appointment.
  • Key personal information, including major stresses, recent life changes and family medical history.
  • All medicines, vitamins or other supplements you take, including the doses.
  • Questions to ask your healthcare professional.

Take a family member or friend along, if possible, to help you remember the information you're given.

For gastrointestinal stromal tumors, some basic questions to ask your healthcare professional include:

  • Do I have cancer?
  • Do I need more tests?
  • What are my treatment options?
  • What are the potential risks of these treatment options?
  • Do any of the treatments cure my cancer?
  • Can I have a copy of my pathology report?
  • How much time can I take to consider my treatment options?
  • Are there brochures or other printed materials that I can take with me? What websites do you recommend?
  • What would happen if I chose not to have treatment?

Don't hesitate to ask other questions.

What to expect from your doctor

Your healthcare professional is likely to ask you several questions, such as:

  • When did your symptoms begin?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
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