BRAF mutations in KIT/PDGFRA positive gastrointestinal stromal tumours (GISTs): Is their frequency underestimated?

BRAF V600E mutations in GISTs are considered to be one of the mutational events in KIT/PDGFRA negative or positive GISTs, respectively. BRAF mutated GISTs usually do not respond to imatinib treatment, even more GISTs with imatinib sensitive KIT mutation. However, they are almost phenotypically and morphologically identical with KIT/PDGFRA positive GISTs. In general, due to the small number of BRAF mutations in GIST and because of the rarity of concomitant BRAF/KIT or BRAF/PDGFRA mutations, their frequency may be depreciated. The aim of this study was BRAF mutation detection in KIT/PDGFRA positive GISTs and their verification by other molecular methods. We applied the sensitive droplet digital PCR on 35 randomly selected KIT/PDGFRA positive GISTs to detect V600E mutations. We have established two criteria for the evaluation of samples: false positive rate (FPR) based on the negative controls; Limit of Detection (LoD) based on the serial dilution of positive control from RKO cell line harboring heterozygous V600E mutation in constant wild-type DNA background. Results from ddPCR were verified by other molecular methods: allele-specific PCR, dideoxysequencing, competitive allele-specific TaqMan PCR (castPCR). FPR was determined as 5 (∼4.4) positive droplets, and LoD was assessed to 3.4293 copies/μL what is the method sensitivity of 0.0162 %. We identified eight KIT/PDGFRA positive patients with concomitant V600E mutation. The five of them were in coexistence with KIT mutation and three with PDGFRA mutation. We also included the liver metastasis, but data from primary tumour were not available. We achieved the very high sensitivity of the ddPCR method for detecting BRAF mutation in GISTs to have importance from the point of view of therapy.

Improvement of energy state and basic modifications of neuropathological damage in rabbits as a result of graded postischemic spinal cord reoxygenation

The role of graded postischemic reoxygenation applied at the end of 20 min of spinal cord ischemia was studied with respect to the intraspinal pO2 tension, energy state, and histopathological sequelae. Graded postischemic reoxygenation can induce a positive shift in the intraspinal pO2 tension, but normal postischemic reoxygenation with normotensive pO2 blood tension inevitably causes the postischemic intraspinal pO2 overshoot. Graded postischemic reoxygenation significantly improves the energy state expressed by higher adenosine triphosphate (ATP), phosphocreatine (PCr) and glucose levels. Using the Nauta impregnating degenerating method, clear histopathological differences were found in the L3-S3 segments after 20 min of ischemia. Apparently divergent damage was observed when normal reoxygenation or graded postischemic reoxygenation was used. Diametrically different histopathological outcomes were obtained with normal reoxygenation and graded postischemic reoxygenation 2 and 4 days postoperatively.