伊马替尼辅助治疗胃肠间质瘤的研究进展与 挑战

Research Advances and Challenges in Imatinib Adjuvant Therapy for Gastrointestinal Stromal Tumours

摘要: 胃肠间质瘤(Gastrointestinal stromal tumor, GIST)是消化系统最常见的间叶源性肿瘤。目前，手术切除仍是GIST的首选治疗方式，但即便实现肿瘤完整切除，术后复发风险仍较高，约30%的患者在随访期间会发生复发或转移。甲磺酸伊马替尼作为一种高选择性酪氨酸激酶抑制剂(Tyrosine kinase inhibitor, TKI)，已显著改变晚期GIST的治疗格局，成为该领域靶向治疗的里程碑式药物。近年来，其在GIST术后辅助治疗中的应用价值受到学界广泛关注。本文系统综述伊马替尼辅助治疗高危GIST的关键研究进展，重点探讨治疗时长对预后的影响、当前临床实践中存在的核心争议以及未来的研究方向，以期为临床诊疗提供参考依据。

Abstract: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the digestive system. At present, surgical resection remains the first-line treatment for GIST. However, even with complete tumor resection, the risk of postoperative recurrence remains high: approximately 30% of patients develop recurrence or metastasis during follow-up. As a highly selective tyrosine kinase inhibitor (TKI), imatinib mesylate has dramatically revolutionized the treatment paradigm of advanced GIST and represents a milestone in targeted therapy for this disease. In recent years, its value as adjuvant therapy for resected GIST has attracted extensive attention in the medical community. This paper systematically reviews the key research progress of adjuvant imatinib therapy in high-risk GIST, focusing on the impact of treatment duration on prognosis, core controversies in current clinical practice, and future research directions, with the aim of providing a reference for clinical diagnosis and treatment.