The gastrointestinal mesothelioma (Gastrointestinal Stromal Tumors, known as GIST) is one of the types of tumours that originate in interintestinal leaf tissue, which accounts for most of the tumours in digestive tracts. Since the concept of gastrointestinal mesothelioma was first introduced by Mazur et al. in 1983, research and understanding on GIST has continued. This paper will provide detailed information on the definition, causes, symptoms, diagnosis, treatment and prevention of GIST.
The definition and origin of GIST is derived from the interleasing tissue of the gastrointestinal tract, which consists mainly of the Cajal inter-cellular cells (Interstitial Cells of Cajal, ICC) around the neurological tracts of the gastrointestinal tract. These cells are positive with c-kit genes, CD117 (cheamase receptor) and CD34 (monomarrow stem antigen) and are closely related to the biological characteristics of the GIST. GIST does not include a smooth musculoma that originates exclusively from a smooth muscle cell or a neurogenic tumour that originates from a nerve cell or a nervous scab.
Causes and morbidity mechanisms
The cause of GIST ‘ s illness is not yet entirely clear, but research shows that its occurrence is closely related to genetic mutation. Genetic mutations lead to abnormal cytological transmission routes, which in turn contribute to the growth and survival of tumour cells. In addition, gastrointestinal mesothelioma due to non-genetic mutation may be associated with the loss of amber acid dehydrogenase, while poor living habits may also increase the risk of gene mutation and eventually lead to tumours.
Incidence groups and areas
GIST is good for the elderly, but it may also affect young people. It is concentrated in the stomach and small intestines, which account for 60-70 per cent of the stomach and 20-30 per cent of the intestines, while the oesophagus and the rectums are less common and very few can occur after the intestinal and even the peritoneal parts.
Symptoms
The clinical symptoms of GIST are diverse and non-specific, depending mainly on the size of the tumor, its location and how it grows. When tumours are smaller, most patients may not have any symptoms and are diagnosed with abdominal swelling only incidentally during medical examinations. As the tumour increases, the patient may suffer from abdominal abdominal pain, abdominal swelling, early saturation and other abdominal disorders, as well as abdominal swelling, abdominal haemorrhage, digestive haemorrhage, and anemia-related deficiencies. Among them, in digestive haemorrhage can be manifested in vomiting, black defecation, blood defecation, etc. In addition, hepatic and abdominal transfer is the most common clinically malignant expression of GIST.
Diagnosis
GIST ‘ s diagnosis relies mainly on video and pathological examinations. Common video screening methods include CT, MRI, ultrasound endoscopy and PET. CT flat-sweeps can detect tumours in circular or class-shaped shapes, with few in irregular shapes. The benign tumours are smaller than 5 cm, evenly dense and sharp on the edge; the malignant tumours are 6 cm or less, and the boundary is unclear and bound to neighbouring organs. Ultrasound endoscopy can assist in the diagnosis of the tumour ‘ s location, size, origin and local immersion. PET examinations compensate for the deficiencies of physical examinations and assess the metabolism of tumours by tracking high-density F18 glucose.
The pathological examination is the gold standard for the diagnosis of GIST. Oncological, immunological and molecular biology tests are carried out to determine the type, severity and prognosis of the tumor.
Treatment
GIST treatment consists mainly of surgical and pharmaceutical treatment. Surgery is the main treatment of GIST, including abdominal surgery, abdominal lens surgery and gastrointestinal lens surgery. The objective of the operation is to remove the tumor in its entirety and to avoid its rupture and its dispersion. After the surgery, the patient ‘ s risk level can be assessed on the basis of the results of the pathological examination, so that the next treatment can be judged. In the case of low- and medium-risk GIST patients, there is no need for after-surgery medication; in the case of high-risk GIST patients, there is a need for target-to-drug treatment.
Common target treatment drugs include first-line Imatini, second-line Shunitini and third-line Rigofini. These drugs can target the inhibition of the activity of the chesamate hormones, which prevents the tumour from continuing to grow or further atrophy and necrosis.
Prevention and lifestyle
Prevention remains a challenging issue, as the exact cause of GIST is not yet entirely clear. However, a healthy lifestyle helps to reduce the risk of certain cancers. It is recommended that more fibre-rich foods such as fruit, vegetables and whole grains be consumed; that the intake of high fats, high salt and pickled foods be reduced; that aerobics of at least 150 minutes ‘ medium intensity be carried out per week; that smoking and overdrinking be avoided; and that periodic medical examinations be conducted, especially for groups with family history or genetic tendencies, to keep their weight within a healthy range.
