Clinic-pathological aspect of gastro-intestinal stromal tumors at tertiary care Hospital India

Autor:	P Suresh, Amamndeep Sing Sandhu, Sankar Subramanian, Jagan Balu
Rok vydání:	2020
Předmět:	medicine.medical_specialty Abdominal pain Stromal cell Tumores estromais gastrointestinais Physical examination RC799-869 Cell morphology Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine Gastro-intestinal stromal tumors CD-117 CD-34 medicine Stromal tumor Prospective cohort study medicine.diagnostic_test Immunohistochemisry business.industry Stomach Diseases of the digestive system. Gastroenterology medicine.anatomical_structure 030220 oncology & carcinogenesis Imuno-histoquímica Immunohistochemistry 030211 gastroenterology & hepatology medicine.symptom business
Zdroj:	Journal of Coloproctology (Rio de Janeiro) v.40 n.1 2020 Journal of Coloproctology (Rio de Janeiro. Online) Sociedade Brasileira de Coloproctologia (SBCP) instacron:SBCP Journal of Coloproctology, Vol 40, Iss 1, Pp 12-19 (2020) Journal of Coloproctology (Rio de Janeiro), Volume: 40, Issue: 1, Pages: 12-19, Published: 23 MAR 2020
ISSN:	2317-6423 2237-9363
DOI:	10.1016/j.jcol.2019.09.006
Popis:	Background: This study defines the disease profile in south Indian population and determine the clinic-pathological aspects of Gastro-Intestinal Stromal Tumors. Method: In this prospective study patients diagnosed of gastrointestinal stromal tumors were taken thorough clinical examination and a database of Anthropometric details and clinical details were analyzed. Pathological data included tumor size, presence or absence necrosis, mitotic counts, immunohistochemistry for CD-117, CD-34. Results: There were 44 patients with confirmed diagnosis of gastro-intestinal stromal tumor. The highest incidence was found in the 6th decade. The most common symptoms were abdominal pain and gastrointestinal bleed. Stomach was most frequent site for gastro-intestinal stromal tumors. Immunochemistry for CD-117 was positive in 93.18% cases. Majority of tumors (79.5%) had pure spindle cell morphology and mitotic activity showed that 34% of the GISTs were of the high risk group. Forty two patients were suggestive of surgery as the primary treatment after presentation. Conclusion: Abdominal pain was the most common presenting complaint. Majority of the tumors aroused from the stomach. The majority of the tumors had pure spindle cell morphology and 93% of the tumors were CD-117 positive. A significant relationship between tumor size, tumor necrosis and mitotic activity with large tumors having necrosis and high mitotic rate having high risk of malignancy, was observed. Surgical resection is considered mainstay of treatment of gastro-intestinal stromal tumor. Imatinib therapy should be given to patients in moderate to severe risk categories. Resumo: Justificativa: Este estudo define o perfil da doença na população do sul da Índia e determina os aspectos clínicos e patológicos dos tumores estromais gastrointestinais. Método: Neste estudo prospectivo, os pacientes diagnosticados com tumor estromal gastrointestinl foram submetidos a um exame clínico completo, e uma série de dados dos pacientes, incluindo detalhes antropométricos e clínicos, foram analisados. Os dados patológicos incluíram tamanho do tumor, presença ou ausência de necrose, contagem mitótica e imuno-histoquímica para CD-117, CD-34. Resultados: Havia 44 pacientes com diagnóstico confirmado de tumor estromal gastrointestinal. A maior incidência foi encontrada na 6ª década de vida. Os sintomas mais comuns foram dor abdominal e sangramento gastrointestinal. O estômago foi o local mais frequente para tumores estromais gastrointestinais. A imuno-histoquímica para CD-117 foi positiva em 93,18% dos casos. A maioria dos tumores (79,5%) apresentava morfologia pura de células fusiformes e a atividade mitótica mostrou que 34% dos GISTs pertenciam ao grupo de alto risco. Quarenta e dois pacientes receberam indicação para cirurgia como tratamento primário após a apresentação. Conclusão: A dor abdominal foi a queixa mais comum. A maioria dos tumores afetava o estômago, apresentava morfologia pura de células fusiformes e 93% eram CD-117 positivos. Foi observada uma relação significativa entre o tamanho do tumor, a necrose tumoral e a atividade mitótica, com os tumores grandes apresentando necrose e alta taxa mitótica com alto risco de malignidade. A ressecção cirúrgica é considerada o principal tratamento do tumor estromal gastrointestinal. A terapia com imatinibe deve ser administrada a pacientes em categoria de risco de moderadas a grave. Keywords: Gastro-intestinal stromal tumors, Immunohistochemisry, CD-117, CD-34, Palavras-chave: Tumores estromais gastrointestinais, Imuno-histoquímica, CD-117, CD-34
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7b2f609699f0651968df0672bb39bce5 https://doi.org/10.1016/j.jcol.2019.09.006 Zobrazit plný text záznamu