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Aim:
Gastrointestinal stromal tumor is the most common mesenchymal neoplasia in the gastrointestinal tract and has a broad spectrum of pathological patterns and also clinical features changing from benign to malignant. Although the well-characterized parameters to predict the outcome have been the size and the mitotic index of the tumor in the pat...
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Gastrointestinal stromal tumors (GISTs) are one of the most common mesenchymal tumor types and usually contain KIT or PDGFRA mutations. GISTs with concomitant low- and high-grade components are seen in clinical practice. Herein, we retrospectively analyzed the histological characteristics and immunohistochemical results of 22 GIST cases with concom...
Background: Gastrointestinal stromal tumors (GIST) are rare mesenchymal neoplasms of the gastrointestinal tract (GIT) that represent approximately 1 to 2 percent of primary gastrointestinal (GI) cancers. Owing to their rarity, very little is known about the overall epidemiology and prognostic factors of the pathology. The purpose of this study is t...
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors found in the gastrointestinal (GI) tract, with the stomach being the most common site. They represent a distinct group of GI tumors originating from the interstitial cells of Cajal and are characterized by gain-of-function mutations of KIT. KIT oncoprotein serves as both...
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Gain of function in receptor tyrosine kinases type III, KIT, or PDGFRA drives the majority of GIST. Previously, our group reported that silencing of the adaptor molecule SH3 Binding Protein 2 (SH3BP2) downregulated KIT and PDGFRA and microp...
A gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. The tumor originates from Cajal cells, which generated peristaltic motion. Primary gastrointestinal stromal tumor of the liver is rare and should be considered in imaging diagnosis. We report a case of an 82-year-old female patient who repres...
Citations
... The expression pattern of DOG-1 in ICCs mirrors its presence in GISTs, suggesting a close relationship between DOG-1, ICCs, and GISTs. This association underscores the utility of DOG-1 in accurately diagnosing GISTs, even in cases where traditional markers like KIT may be negative [25,34,[41][42][43]. Our study revealed a prevalent DOG-1 expression in a significant proportion of the study group, counting for a prevalence of 92.86% (13 patients). ...
... Hirota et al. found that approximately 72-78% of GIST lesions tested positive for CD 34 [22]. Previous research studies have shown higher positivity rates for the same marker, with West et al. reporting 97.8% positivity [23], and Sözütek et al. reporting 87% positivity [24]. Additional studies have indicated that 30-40% of GIST cases exhibit positivity for SMA, while only 5% show positivity for S-100 protein [22,25,26]. ...
... Pathohistological conclusion -neuroendocrine tumor. GIST was verified by the CD 117 and DOG-1 markers [8], and a high-grade tumor (G2) by the number of mitotic figures was verified by the IHC examination in the certified laboratory CSD (Kyiv). Molecular research revealed a mutation of the KIT gene in exon 11 -a variant that is present in 67% of GIST cases [9]. ...
Objective:
The aim: To analyze the results of treatment even in limited groups of patients.
Patients and methods:
Materials and methods: Clinical cases of GIST based on the materials of the surgical clinic of the Central Municipal Hospital in Uzhgorod (Transcarpathian region) were discussed. Clinical, ultrasound and CT monitoring was provided. CT dynamics were assessed according to RECIST 1.1.
Conclusion:
Conclusions: Only surgery resection is enough in case of the "small" tumor originated from the stomach. Otherwise, in case of locally-widespread GIST it is expedient to refrain from radical surgical intervention. High-grade GIST was verified by the IHC examination with mutation of the KIT gene in exon 11. Imatinib mesylate 400 mg PO daily was prescribed. More than 1-year follow-up result: firstly more than 50% reduction of the tumor size with subsequent stabilization of the disease. Minimally invasive processes allow surgical interventions and do not require aggressive adjuvant therapy. The presence of a giant GIST is a serious diagnostic and treatment challenge. Only management of the patient by a multidisciplinary team allows to resolve diagnostic and treatment contradictions, to create the prospect of achieving complete or partial remission and long-term survival.
... The Ki-67 expression index is highly related to cell proliferation and growth and has become one of the most widely used biomarkers for evaluating cell proliferation (24). Currently, the Ki-67 index is widely used to predict the proliferative potential of malignant tumors, and its potential as a reliable marker of malignant tumors has been shown in breast, lung, prostate, cervical, and central nervous system cancers (25). Studies have also shown that Frontiers in Surgery the expression of Ki-67 is closely related to mitotic count (23,26,27). ...
IntroductionTo investigate the correlations between the Ki-67 index and plain-scan computerized tomography (CT) signs and pathological features of gastrointestinal stromal tumor (GIST) tissue.Materials and methodsData from 186 patients with GIST diagnosed by pathology and immunohistochemistry (IHC) in Peking University First Hospital from May 2016 to May 2022 were analyzed. The patients were divided into two groups: Ki-67 ≤5% and >5%. Correlation analysis, univariate and multivariate Logistic regression analysis were used to explore the correlations between CT signs, pathological features, and Ki-67 expression.ResultsUnivariate indicators correlated with the Ki-67 index were mitotic count, pathological grade, tumor hemorrhage, tumor necrosis, tumor size, and tumor density. Multivariate Logistic regression indicated that the mitotic count [odds ratio (OR) 10.222, 95% confidence interval (CI) 4.312–31.039], pathological grade (OR 2.139, 95% CI 1.397–3.350), and tumor size (OR 1.096, 95% CI 1.020–1.190) were independently associated with the Ki-67 expression level. The concordance indexes (C-index) for the pathological features and CT signs models were 0.876 (95% CI 0.822–0.929) and 0.697 (95% CI 0.620–0.774), respectively, with positive predictive values of 93.62% and 58.11% and negative predictive values of 81.29% and 75.89%, respectively. After internal verification by the Bootstrap method, the fitting degree of the pathological features model was found to be better than that of the CT signs model.Conclusion
Mitotic count, pathological risk grading, and tumor size are independent risk factors correlating with high Ki-67 index. These results indicate that the Ki-67 index reflects tumor malignancy and can predict recurrence and metastasis of GIST.
... The presence of KIT/CD117 mutations was found in greater than 90% of GIST diagnoses [3,5]. DOG-1 is another common marker seen with GIST [1,5,6]. DOG-1 was not present in our case but was found in 98% of GISTs [5]. ...
... DOG-1 was not present in our case but was found in 98% of GISTs [5]. A biopsy can reveal 3 different morphological patterns, spindle cells, epithelioid and mixed [1,3,4,6]. The morphology of GISTs is predominantly spindle cell, as was the case in our patient, and was reported in about 70% of cases [3,6]. ...
... A biopsy can reveal 3 different morphological patterns, spindle cells, epithelioid and mixed [1,3,4,6]. The morphology of GISTs is predominantly spindle cell, as was the case in our patient, and was reported in about 70% of cases [3,6]. ...
Gastrointestinal stromal tumors (GISTs) albeit rare, are the most common mesenchymal neoplasms of our gastrointestinal (GI) tract. GISTs present with nonspecific symptoms and are found incidentally on endoscopy or imaging. A significant portion of GIST diagnoses expresses KIT/CD117 and DOG-1 tissue markers which are pathognomonic for GIST. More recently, Ki-67 was found to be a significant prognostic marker for determining the risk of recurrence. We present a patient with a mesenchymal mass in the small intestine with pathognomonic features of GIST and expression of Ki-67, an important immunocytochemical marker of proliferation.
The patient was a 71-year-old male with a history of hyperlipidemia and hypertension. He presented to the emergency department complaining of bloody diarrhea for two days, with associated nausea, vomiting, and abdominal cramping. Initial blood pressure on presentation was 77/52 mm Hg. Computed tomography (CT) of the abdomen and pelvis revealed a large solid mass with cystic components. The mass was not visualized with esophagogastroduodenoscopy or colonoscopy, and surgical intervention was warranted. A 14 cm x 11.5 cm x 10 cm tumor was found in the ileum. The tumor was excised with small bowel segmental resection and the specimen was sent for pathological evaluation. Immunohistochemical analysis confirmed the diagnosis of GIST with diffuse CD117/c-Kit protein expression. The tumor was high grade with a high mitotic rate at 30 mitoses/50 high-power fields (HPF) and had spindle cell morphology. Of note, 10% of the tumor cells were positive for Ki-67.
GISTs have a high risk of recurrence and a more favorable prognosis with advancements in management. Prior to imatinib therapy in the early 2000s, GISTs prognosis was very poor, as they are resistant to most conventional chemotherapeutic agents and radiation. While the prognosis is fair, surgical resection and imatinib therapy have improved outcomes and risk of recurrence. Prognosis and risk of recurrence can be determined by assessing the mitotic rate, tumor size, and recently, expression of Ki-67. Ki-67 provides a reliable and reproducible approach to assess the prognosis of GIST.
... DOG 1 mutation analysis has been reported as one of the prognostic factors in both early and advance stage cases. [10][11][12][13] Most GISTs are mesenchymal tumors that express KIT. There is also a small group of GIST that shows mutation activation in PDGFRA. ...
... DOG 1 mutation analysis has been reported as one of the prognostic factors in both early and advance stage cases. [10][11][12][13] Most GISTs are mesenchymal tumors that express KIT. There is also a small group of GIST that shows mutation activation in PDGFRA. ...
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of gastrointestinal tract that originate from Interstitial Cell of Cajal (ICC). The correct diagnosis of GISTs is important for therapeutic reasons of imatinib. Recently, DOG-1 has been introduced as an important diagnostic marker with high sensitivity and specificity. We report a caseof 40 years old woman with pain and swollen stomach in left lower quadrant since four month before come to the hospital. Ultrasound examination showed hipoechoic lession in the posterior of uterus and ascites. Paraovarian mass attached to the transverse colon and ascites was found on surgery. Histopathology diagnosis was a mesenchymal stromal tumour suggestive malignant GIST. Citological examination of asites fluid show a malignancy metastases. Immunohistochemistry showed negative for c-kit and positive for DOG-1, the conclusion is a GIST. Immunohistochemistry examinations are important to make defenitive diagnosis for GIST. C-kit-negative GIST sare still rare, but defenitive diagnosis must be made because related to target therapy. DOG 1 has been proven in 89% of c-kit-negative GIST and claimed more sensitive and spesific.Keywords: GIST, c-kit, DOG-1, ICC, paraovary
... On the other hand, Ki-67 can be a stronger candidate for prognostic factor instead of mitotic index to identify the proliferative cells out of mitotic phase but this statement needs be prospectively validated on studies with large number of patients. [11] DOG1 seems to be an important diagnostic tool for clinically suspected GIST diagnosis in both advanced and early staged patients whose tumors are c-kit expression negative. The patient was advised to undergo further investigation including endoscopic examination of the GI tract for the detection of primary GIST but was lost to the follow-up. ...
... There are several antibodies that express in GISTs [9,10]. However, it seems that CD117, a marker of intestinal Cajal cells, and DOG1, primarily discovered on GISTs, are the antibodies of choice in the diagnosis of GISTs [11]. ...
Introduction
Gastrointestinal stromal tumors (GISTs), although not common in gastrointestinal (GI) tumors, constitute the most frequent mesenchymal tumors of the GI tract. This report describes a patient with a large sporadic GIST at proximal jejunum that mimicked the pancreatic cystic neoplasm.
Case presentation
We report a 59-year-old female patient with unexplained weight loss and palpable left upper quadrant abdominal mass for 6 months. Computed tomography (CT) scan demonstrated a heterogeneously mass measuring 10 cm in a maximal diameter at pancreatic body and tail. Laparotomy was done, and the tumor was found at proximal jejunum closed to the ligament of Treitz, so en bloc resection of the tumor was done. The pathological and immunohistochemical study confirmed GISTs.
Discussion
Although most GISTs are originated from the intestine, they frequently arise from the stomach, the duodenum and rarely from the jejunum. And jejunal GISTs are usually asymptomatic. The misdiagnosis as mucinous cystadenoma of this case might be due to the proximity of the tumor to the body and tail of pancreas, and compressing the adjacent organ due to its large size.
Conclusion
GISTs are most frequently small and arising from the stomach. GISTs are rarely present as a large tumor of the jejunum, and particularly mimicked a pancreatic tumor.
... In this study, a rate of positivity of 82.4% for c-kit and 75.0% for DOG1 was obtained, which were comparable to other similar studies. [5,12,13] In 16 cases, although c-kit was negative, a positive DOG1 helped to confirm the diagnosis. This explains that DOG1 can serve as a good complementary marker to c-kit. ...
Introduction:
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. We analyzed the clinicopathological features, resectability, immunohistochemical markers, and various factors predictive of disease recurrence and survival.
Materials and methods:
Retrospective analysis of prospectively maintained database of GIST patients managed from 2005 to 2016 was done. Size, site, malignant potential, nuclear pleomorphism, histopathological variety, immunohistochemical markers, type of surgery, and adjuvant imatinib therapy were analyzed.
Results:
Ninety-two patients with GIST were analyzed. Immunohistochemistry showed positivity for c-kit (82.4%), DOG1 (75%), and PDGFR-α (79%). Among 16 patients with c-kit-negative tumors, 10 patients were positive for DOG1, PDGFR-α, or both. The most common primary site was stomach (44, 47.8%) followed by small bowel (17, 18.5%) and duodenum (14, 15.2%). Of 92 patients, 80 (87%) underwent R0 resection with organ sparing resection in 56 (70%) patients. Seventeen (21.3%) patients showed recurrence at a median follow-up of 6 years. Median and 5-year overall survival (OS) was 36 months (12-120) and 75%, respectively, and 5-year RFS was 81.8%. On univariate analysis, size, mitotic activity, malignant potential, and nuclear pleomorphism were predictors of recurrence. However, on multivariate analysis, only nuclear pleomorphism was significant.
Conclusions:
GISTs had a wide spectrum of presentation, and immunohistopathological features with organ sparing resection were conceivable in maximum. Nuclear pleomorphism may be considered as an important variable to predict recurrence in addition to malignant potential of tumors.
