scholarly journals Histopathological Characteristics of Gastrointestinal Stromal Tumors in a Cohort of Vietnamese Patients

2020 ◽  
Vol 13 ◽  
pp. 2632010X2097240
Author(s):  
Pham Nguyen Cuong ◽  
Nguyen Thanh Xuan ◽  
Tran Xuan Tien ◽  
Pham Nhu Huy ◽  
Pham Nguyen Tuong
Keyword(s):  
High Risk ◽  
Gastrointestinal Stromal Tumors ◽  
Histopathological Examination ◽  
Armed Forces ◽  
Risk Groups ◽  
Low Risk ◽  
Stromal Tumors ◽  
Primary Gist ◽  
Mesenchymal Neoplasms ◽  
The Relationship

Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal system. Histopathological examination takes an important part in confirming the subtypes of GISTs, to choose appropriate therapeutics for patients. This study aims to explore the histopathological characteristics and evaluate the relationship between malignant risk classification (according to Armed Forces Institute of Pathology criteria) and the histopathological features of GISTs in a cohort of Vietnamese patients. Methods: We reviewed 89 patients with primary GIST who underwent surgery between 2014 and 2019 at Hue Central Hospital, Vietnam. We investigated histopathological characteristics and immunohistochemical findings of all patients. Results: The average age was 55.9 ± 11.9 years. A tumor size of 2-5 cm accounted for 64.1%. The most common position was at the stomach which accounted for 48.5%. Among the subtypes of GIST, spindle cells were seen in 85.9% of patients; epithelial form 10.9%; multi-morphology (3.2%). 97.4% of the samples were positive for CD117, 61.5% of cases were positive for CD34; and no case was positive for Desmin. The rate of high-risk GIST was dominant (46.9%) as compared to the intermediate-risk (28.1%), low-risk (0.3%-2%), and very low-risk groups (4.7%). Conclusions: This study demonstrates the histopathological characteristics of GIST and emphasizes the significant rate of high-risk GIST.

scholarly journals The Inside Mystery of Jejunal Gastrointestinal Stromal Tumor: A Rare Case Report and Review of the Literature

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
A. K. Dhull ◽  
V. Kaushal ◽  
R. Dhankhar ◽  
R. Atri ◽  
H. Singh ◽  
...  
Keyword(s):  
High Risk ◽  
Imatinib Mesylate ◽  
Gastrointestinal Stromal Tumors ◽  
Rare Case ◽  
Immunohistochemical Analysis ◽  
Resected Specimen ◽  
Stromal Tumors ◽  
Primary Gist ◽  
Large Size ◽  
Operative Findings

Gastrointestinal stromal tumors (GISTs) are malignant and rare form of soft tissue sarcoma of the digestive tract. The incidence of gastrointestinal stromal tumors is very low Kramer et al. 2005 Jejunal GISTs are extremely rare. Here we present a rare case of jejunal GIST with unusually large size at presentation. The patient presented with severe abdomen pain, exophytic growth, and dimorphic anemia. Surgical resection of the tumor was carried out, and operative findings revealed a 15 × 10 cm growth, arising from serosal surface of jejunum, at the antimesenteric surface. Diagnosis in this case was made by subjecting the resected specimen to immunohistochemical analysis. In view of large size of the resected tumor, and high-risk histopathological features, imatinib mesylate 400 mg once daily was given as adjuvant chemotherapy. Patient is asymptomatic without any evidence of tumor recurrence after six months of postoperative followup. Imatinib as such is recommended in metastatic, residual or recurrent cases of GISTs or which are surgically not removable; however, recent recommendations suggests the use of imatinib mesylate after radical surgery in high-risk cases, because it has shown a significant decrease in the recurrence rate, and the Food and Drug Administration (FDA) has also approved the use of imatinib as adjuvant therapy after complete resection of localized, primary GIST.

Biological and clinical significance of cytogenetic abnormalities in low-risk and high-risk gastrointestinal stromal tumors

2002 ◽  
Vol 33 (3) ◽  
pp. 316-321 ◽  
Author(s):  
Bastian Gunawan ◽  
Frank Bergmann ◽  
Jörg Höer ◽  
Claus Langer ◽  
Volker Schumpelick ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Significance ◽  
Gastrointestinal Stromal Tumors ◽  
Low Risk ◽  
Cytogenetic Abnormalities ◽  
Stromal Tumors

scholarly journals MRI-Based Radiomics Models for Predicting Risk Classification of Gastrointestinal Stromal Tumors

2021 ◽  
Vol 11 ◽  
Author(s):  
Haijia Mao ◽  
Bingqian Zhang ◽  
Mingyue Zou ◽  
Yanan Huang ◽  
Liming Yang ◽  
...  
Keyword(s):  
High Risk ◽  
Random Forest ◽  
Gastrointestinal Stromal Tumors ◽  
Roc Curves ◽  
Risk Classification ◽  
Low Risk ◽  
Intermediate Risk ◽  
Stromal Tumors ◽  
Mr Sequences

BackgroundWe conduct a study in developing and validating four MRI-based radiomics models to preoperatively predict the risk classification of gastrointestinal stromal tumors (GISTs).MethodsForty-one patients (low-risk = 17, intermediate-risk = 13, high-risk = 11) underwent MRI before surgery between September 2013 and March 2019 in this retrospective study. The Kruskal–Wallis test with Bonferonni correction and variance threshold was used to select appropriate features, and the Random Forest model (three classification model) was used to select features among the high-risk, intermediate-risk, and low-risk of GISTs. The predictive performance of the models built by the Random Forest was estimated by a 5-fold cross validation (5FCV). Their performance was estimated using the receiver operating characteristic (ROC) curve, summarized as the area under the ROC curve (AUC). Area under the curve (AUC), accuracy, sensitivity, and specificity for risk classification were reported. Linear discriminant analysis (LDA) was used to assess the discriminative ability of these radiomics models.ResultsThe high-risk, intermediate-risk, and low-risk of GISTs were well classified by radiomics models, the micro-average of ROC curves was 0.85, 0.81, 0.87 and 0.94 for T1WI, T2WI, ADC and combined three MR sequences. And ROC curves achieved excellent AUCs for T1WI (0.85, 0.75 and 0.82), T2WI (0.69, 0.78 and 0.78), ADC (0.85, 0.77 and 0.80) and combined three MR sequences (0.96, 0.92, 0.81) for the diagnosis of high-risk, intermediate-risk, and low-risk of GISTs, respectively. In addition, LDA demonstrated the different risk of GISTs were correctly classified by radiomics analysis (61.0% for T1WI, 70.7% for T2WI, 83.3% for ADC, and 78.9% for the combined three MR sequences).ConclusionsRadiomics models based on a single sequence and combined three MR sequences can be a noninvasive method to evaluate the risk classification of GISTs, which may help the treatment of GISTs patients in the future.

Sex Differences in the Relationship Between High-Risk Drinking and the Triglyceride-Glucose (TyG) Index: An Analysis Using 2013 and 2015 Korean National Health and Nutrition Examination Survey Data

2020 ◽  
Author(s):  
Yea-Chan Lee ◽  
Byong Jin Park ◽  
Jun-Hyuk Lee
Keyword(s):  
High Risk ◽  
National Health ◽  
Risk Groups ◽  
Low Risk ◽  
Excessive Drinking ◽  
Tyg Index ◽  
Health And Nutrition ◽  
Audit Score ◽  
High Risk Drinking ◽  
The Relationship

Abstract Aims The alcohol use disorders identification test (AUDIT) was developed to evaluate excessive drinking in primary care. The triglyceride (TG) glucose (TyG) index is a novel marker used for assessing insulin resistance. We sought to document relationships between high-risk drinking according to AUDIT and the TyG index and to evaluate whether the TyG index is more correlated with high-risk drinking than TG or fasting plasma glucose (FPG). Methods We analyzed data for 7014 participants in the 2013 and 2015 Korea National Health and Nutrition Examination Surveys. Excessive drinking risk groups were categorized according to AUDIT scores (low-risk, 0–7 in men and 0–6 in women; moderate-risk, 8–14 in men and 7–12 in women; and high-risk, ≥15 in men and ≥13 in women). Results In men, compared with low-risk individuals, the odds ratios (95% confidence intervals) for higher TyG index values were 1.84 (1.16–2.93) in the moderate- and 2.82 (1.86–4.30) in the high-risk groups. The correlation coefficient for the TyG index and AUDIT score was significantly higher than those for TG and FPG. No significant associations were noted in women. Conclusion High-risk drinking is significantly associated with higher TyG index values in men only. The TyG index can be a novel marker for assessing high-risk drinking in men.

The Relationship Between CT Signs of Computed Tomography and Risk Classification of Gastric Stromal Tumors

2021 ◽  
Vol 11 (2) ◽  
pp. 642-647
Author(s):  
Wang Chen ◽  
Rong Guo ◽  
WeiGao Sun ◽  
DingYou Lu
Keyword(s):  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Risk Classification ◽  
Low Risk ◽  
Stromal Tumors ◽  
Medium Risk ◽  
Solid Part ◽  
The Relationship

Objective: The study aims to explore the role of computed tomography (CT) in clinical diagnosis, thus having a preliminary understanding of the relationship between CT signs and the risk of gastric stromal tumors (GSTs). Methods: In this study, 213 patients with GST with complete preoperative CT and postoperative pathological results in Yancheng No. 1 People's Hospital from January 2016 to August 2019 are selected as research objects. The patient's basic information is collected. CT machine (Toshiba 320 row CT and Siemens dualsource CT (Somatom Definition Flash)) is used to examine all patients. The obtained image data are evaluated. Patients are divided into low-risk group, medium risk group and high-risk group according to the risk classification standard of GST. The data collected are analyzed statistically. Results: After risk classification of all patients, 87 patients in low-risk group, 74 in medium-risk group and 52 in high-risk group are found. After further analysis of the risk classification, it is found that there is no significant difference in GST risk classification between the tumor sites (P > 0.05). In the GST risk classification, the smaller the tumor, the more the low-risk group, the larger the tumor, the more the high-risk group, the difference is statistically significant (P < 0.05). In the observation of the relationship between tumor growth pattern and risk classification, it is found that the number of intraluminal growth is the most, while mixed growth is the least (P < 0.05). Further analysis of tumor density, solid part enhancement, distant metastasis and risk grade show that there are significant differences (P < 0.05). Conclusion: As an auxiliary diagnostic method in clinic, CT signs can be used to analyze the relationship with risk grade from tumor location, tumor size, tumor growth mode, tumor density, solid part enhancement degree and tumor distant metastasis, so as to have a more accurate understanding of patients' situation, and provide experimental basis for the later application of CT signs in tumor and auxiliary diagnosis.

scholarly journals A Novel Inflammatory lncRNAs Prognostic Signature for Predicting the Prognosis of Low-Grade Glioma Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Zijin Xiang ◽  
Xueru Chen ◽  
Qiaoli Lv ◽  
Xiangdong Peng
Keyword(s):  
High Risk ◽  
Risk Model ◽  
Risk Group ◽  
Risk Groups ◽  
High Risk Group ◽  
Low Risk ◽  
Low Grade ◽  
Prognostic Signature ◽  
The Relationship ◽  
Genome Atlas

BackgroundAs immunotherapy has received attention as new treatments for brain cancer, the role of inflammation in the process of glioma is of particular importance. Increasing studies have further shown that long non-coding RNAs (lncRNAs) are important factors that promote the development of glioma. However, the relationship between inflammation-related lncRNAs and the prognosis of glioma patients remains unclear. The purpose of this study is to construct and validate an inflammation-related lncRNA prognostic signature to predict the prognosis of low-grade glioma patients.MethodsBy downloading and analyzing the gene expression data and clinical information of the Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA) patients with low-grade gliomas, we could screen for inflammatory gene-related lncRNAs. Furthermore, through Cox and the Least Absolute Shrinkage and Selection Operator regression analyses, we established a risk model and divided patients into high- and low-risk groups based on the median value of the risk score to analyze the prognosis. In addition, we analyzed the tumor mutation burden (TMB) between the two groups based on somatic mutation data, and explored the difference in copy number variations (CNVs) based on the GISTIC algorithm. Finally, we used the MCPCounter algorithm to study the relationship between the risk model and immune cell infiltration, and used gene set enrichment analysis (GSEA), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses to explore the enrichment pathways and biological processes of differentially expressed genes between the high- and low-risk groups.ResultsA novel prognostic signature was constructed including 11 inflammatory lncRNAs. This risk model could be an independent prognostic predictor. The patients in the high-risk group had a poor prognosis. There were significant differences in TMB and CNVs for patients in the high- and low-risk groups. In the high-risk group, the immune system was activated more significantly, and the expression of immune checkpoint-related genes was also higher. The GSEA, GO, and KEGG analyses showed that highly expressed genes in the high-risk group were enriched in immune-related processes, while lowly expressed genes were enriched in neuromodulation processes.ConclusionThe risk model of 11 inflammation-related lncRNAs can serve as a promising prognostic biomarker for low-grade gliomas patients.

scholarly journals The Incidence of Gastrointestinal Stromal Tumors in Obese Patients—A Large Single Center Experience

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1242
Author(s):  
Natalia Dowgiałło-Gornowicz ◽  
Klaudia Sztaba ◽  
Paweł Lech ◽  
Anna Botulińska ◽  
Maciej Michalik
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Histopathological Examination ◽  
Low Risk ◽  
Risk Category ◽  
Morbidly Obese ◽  
Resected Stomach ◽  
Obese Patients ◽  
Preoperative Body Mass Index ◽  
Stromal Tumors ◽  
The Mean

Background and Objectives: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms located mainly in the fundus (60–70%). The incidence of GIST is approximately 10 per million population per year in Europe, with a peak incidence at the age of 63. Recent studies suggest that morbidly obese patients have a higher incidence of GIST than the general population. The aim of this study was to analyze the incidence of GIST in patients undergoing laparoscopic sleeve gastrectomy (LSG) in our department. Materials and Methods: this paper present the retrospective study of prospectively collected data of 1564 patients who underwent LSG in a single large bariatric center from October 2013 to September 2021. After surgery, each sample of the resected stomach was sent for histopathological examination. For the analysis, we included patients diagnosed with GIST intraoperatively or postoperatively. Results: GISTs were found in five patients (0.31%). There were three men and two women. The mean age was 50.2 (range 32–63 ± 11.8) and the mean preoperative body mass index was 43.3 kg/m2 (40–49.4 ± 3.2). In four cases, GISTs were found in the fundus (80%), and in one in the pylorus (20%). None of the tumors were larger than 7 mm in diameter and all were diagnosed as a very low-risk category. No adjuvant treatment was required. All patients achieved good or satisfactory bariatric and metabolic results. Conclusions: The incidence of GIST in our study was estimated at 0.31%. All patients had a very low-risk GIST and no recurrence until follow-up. Recent literature suggests that the risk of GIST is higher in the obese population, and therefore surgeons should be aware of the risk of incidental GIST during LSG.

scholarly journals Role of endoscopic ultrasonography for differential diagnosis of upper gastrointestinal submucosal lesions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qian Su ◽  
Jin Peng ◽  
Xiong Chen ◽  
Zhiming Xiao ◽  
Rui Liu ◽  
...  
Keyword(s):  
High Risk ◽  
Diagnostic Accuracy ◽  
Endoscopic Ultrasonography ◽  
Muscularis Propria ◽  
Risk Groups ◽  
Low Risk ◽  
Muscularis Mucosa ◽  
Stromal Tumors ◽  
Submucosal Lesions ◽  
Upper Gastrointestinal

Abstract Objective To determine the accuracy of endoscopic ultrasonography (EUS) in the diagnosis of upper gastrointestinal submucosal lesions (SMLs). Methods This was a retrospective study involving patients diagnosed with SMLs using EUS and confirmed by histopathology from November 2014 to December 2020 at The Third Xiangya Hospital of Central South University. Results A total of 231 patients with SMLs were examined by EUS. Histologically, 107 lesions were stromal tumors, and 75 lesions were leiomyomas. Stromal tumors were mainly located in the stomach (89.7%), and leiomyomas were predominantly seen in the esophagus (69.3%). The diagnostic accuracy of EUS for stromal tumors and leiomyomas was 80.4% and 68.0%, respectively. The diagnostic accuracy was highest for lesions located in the muscularis mucosa. The mean diameter of stromal tumors measured using EUS was significantly larger than that of leiomyomas (21.89 mm vs. 12.35 mm, p < 0.001). Stromal tumors and leiomyomas originated mainly from the muscularis propria (94.4%) and the muscularis mucosa (56.0%), respectively. Compared with the very low-risk and low-risk groups of stromal tumors according to the National Institute of Health guidelines, the intermediate-risk and high-risk groups were more likely to have a lesion > 3 cm (p < 0.001) and a surface ulcer (p < 0.01) identified by EUS. Conclusions EUS has good diagnostic value for the diagnosis of upper gastrointestinal SMLs based on the lesion size and the muscle layer of origin. The diagnostic accuracy of EUS lesions is related to the origin, and the diagnostic accuracy is greatest in the mucosal muscularis layer. Stromal tumors > 3 cm and a surface ulcer on EUS are likely to be intermediate or high risk for invasion.

PET Parameters are Useful in Predicting Endometrial Cancer Risk Classes and Prognosis

2020 ◽  
Author(s):  
Adnan Budak ◽  
Emrah Beyan ◽  
Abdurrahman Hamdi Inan ◽  
Ahkam Göksel Kanmaz ◽  
Onur Suleyman Aldemir ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Myometrial Invasion ◽  
Risk Groups ◽  
Total Sample ◽  
Tumor Stage ◽  
Low Risk ◽  
Tumor Diameter ◽  
Grade 3 ◽  
Fdg Pet Ct

Abstract Aim We investigate the role of preoperative PET parameters to determine risk classes and prognosis of endometrial cancer (EC). Methods We enrolled 81 patients with EC who underwent preoperative F-18 FDG PET/CT. PET parameters (SUVmax, SUVmean, MTV, TLG), grade, histology and size of the primary tumor, stage of the disease, the degree of myometrial invasion (MI), and the presence of lymphovascular invasion (LVI), cervical invasion (CI), distant metastasis (DM) and lymph node metastasis (LNM) were recorded. The relationship between PET parameters, clinicopathological risk factors and overall survival (OS) was evaluated. Results The present study included 81 patients with EC (mean age 60). Of the total sample, 21 patients were considered low risk (endometrioid histology, stage 1A, grade 1 or 2, tumor diameter < 4 cm, and LVI negative) and 60 were deemed high risk. All of the PET parameters were higher in the presence of a high-risk state, greater tumor size, deep MI, LVI and stage 1B-4B. MTV and TLG values were higher in the patients with non-endometrioid histology, CI, grade 3 and LNM. The optimum cut-off levels for differentiating between the high and low risk patients were: 11.1 for SUVmax (AUC = 0.757), 6 for SUVmean (AUC = 0.750), 6.6 for MTV(AUC = 0.838) and 56.2 for TLG(AUC = 0.835). MTV and TLG values were found as independent prognostic factors for OS, whereas SUVmax and SUVmean values were not predictive. Conclusions The PET parameters are useful in noninvasively differentiating between risk groups of EC. Furthermore, volumetric PET parameters can be predictive for OS of EC.

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