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Cantú-Soriano GN, Padilla-Rodríguez ÁL. [Intestinal calcifying fibrous tumor: case report]. Rev Esp Patol 2024; 57:137-140. [PMID: 38599735 DOI: 10.1016/j.patol.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/14/2023] [Accepted: 11/23/2023] [Indexed: 04/12/2024]
Abstract
Calcifying fibrous tumor (CFT) is a rare benign lesion of mesenchymal origin that may present similar characteristics to other more common tumors. We present the case of a 36-year-old woman with a tumor in the proximal jejunum, initially suspected to be a gastrointestinal stromal tumor (GIST). Surgical resection was performed, revealing a well-demarcated nodule at the anti-mesenteric border with microscopic features typical of a calcifying fibrous tumor. The tumor cells were positive for CD34 and negative for other markers, differentiating it from other neoplasms. Calcifying fibrous tumors can be confused with more common tumors because of its appearance, but an accurate diagnosis supported by immunohistochemistry is essential. Complete surgical excision is usually curative.
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Affiliation(s)
- Gonzalo Nathaniel Cantú-Soriano
- DIGIPATH (Digital Pathology Laboratory), Escuela de Medicina Universidad Panamericana, Campus Ciudad de México, Ciudad de México, México
| | - Álvaro Lezid Padilla-Rodríguez
- DIGIPATH (Digital Pathology Laboratory), Escuela de Medicina Universidad Panamericana, Campus Ciudad de México, Escuela de Medicina Instituto Tecnológico y de Estudios Superiores de Monterrey, Campus Ciudad de México, Ciudad de México, México.
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2
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Zeng J, Li K, Cao F, Zheng Y. The development of a prediction model based on deep learning for prognosis prediction of gastrointestinal stromal tumor: a SEER-based study. Sci Rep 2024; 14:6609. [PMID: 38504089 PMCID: PMC10951333 DOI: 10.1038/s41598-024-56701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/09/2024] [Indexed: 03/21/2024] Open
Abstract
Accurately predicting the prognosis of Gastrointestinal stromal tumor (GIST) patients is an important task. The goal of this study was to create and assess models for GIST patients' survival patients using the Surveillance, Epidemiology, and End Results Program (SEER) database based on the three different deep learning models. Four thousand five hundred thirty-eight patients were enrolled in this study and divided into training and test cohorts with a 7:3 ratio; the training cohort was used to develop three different models, including Cox regression, RSF, and DeepSurv model. Test cohort was used to evaluate model performance using c-index, Brier scores, calibration, and the area under the curve (AUC). The net benefits at risk score stratification of GIST patients based on the optimal model was compared with the traditional AJCC staging system using decision curve analysis (DCA). The clinical usefulness of risk score stratification compared to AJCC tumor staging was further assessed using the Net Reclassification Index (NRI) and Integrated Discrimination Improvement (IDI). The DeepSurv model predicted cancer-specific survival (CSS) in GIST patients showed a higher c-index (0.825), lower Brier scores (0.142), and greater AUC of receiver operating characteristic (ROC) analysis (1-year ROC:0.898; 3-year:0.853, and 5-year ROC: 0.856). The calibration plots demonstrated good agreement between the DeepSurv model's forecast and actual results. The NRI values ( training cohort: 0.425 for 1-year, 0.329 for 3-year and 0.264 for 5-year CSS prediction; test cohort:0.552 for 1-year,0.309 for 3-year and 0.255 for 5-year CSS prediction) and IDI (training cohort: 0.130 for 1-year,0.141 for 5-year and 0.155 for 10-year CSS prediction; test cohort: 0.154 for 1-year,0.159 for 3-year and 0.159 for 5-year CSS prediction) indicated that the risk score stratification performed significantly better than the AJCC staging alone (P < 0.001). DCA demonstrated the risk score stratification as more clinically beneficial and discriminatory than AJCC staging. Finally, an interactive native web-based prediction tool was constructed for the survival prediction of GIST patients. This study established a high-performance prediction model for projecting GIST patients based on deep learning, which has advantages in predicting each person's prognosis and risk stratification.
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Affiliation(s)
- Junjie Zeng
- Department of Gastrointestinal Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Kai Li
- Department of Gastrointestinal Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Fengyu Cao
- Department of Gastrointestinal Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Yongbin Zheng
- Department of Gastrointestinal Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China.
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Martí-Obiol R, Martí-Fernández R, Fernández-Moreno MC, Barrios-Carvajal ME, López-Mozos F. Characteristics of gastrointestinal stromal tumors associated to other tumors: Características de los tumores del estroma gastrointestinal asociados a otras neoplasias. Cir Esp 2024; 102:135-141. [PMID: 38135151 DOI: 10.1016/j.cireng.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/02/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION Our aim is to analyze the differences between sporadic gastrointestinal stromal tumors and those associated with other tumors. METHODS Retrospective cohort study including patients with diagnosis of gastrointestinal stromal tumors operated at our center. Patients were divided into two groups, according to whether or not they had associated other tumors, both synchronously and metachronously. Disease free survival and overall survival were calculated for both groups. RESULTS 96 patients were included, 60 (62.5%) were male, with a median age of 66.8 (35-84). An association with other tumors was found in 33 cases (34.3%); 12 were synchronous (36.3%) and 21 metachronous (63.7%). The presence of mutations in associated tumors was 70% and in non-associated tumors 75%. Associated tumors were classified as low risk tumors based on Fletcher's stratification scale (p = 0.001) as they usually were smaller in size and had less than ≤5 mitosis per 50 HPF compared to non-associated tumors. When analyzing overall survival, there were statistically significant differences (p = 0,035) between both groups. CONCLUSION The relatively high proportion of gastrointestinal stromal tumors cases with associated tumors suggests the need to carry out a study to rule out presence of a second neoplasm and a long-term follow-up should be carried out in order to diagnose a possible second neoplasm. Gastrointestinal stromal tumors associated with other tumors have usually low risk of recurrence with a good long-term prognosis.
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Affiliation(s)
- Roberto Martí-Obiol
- Upper Gastrointestinal Surgery Unit, Hospital Clínico Universitario, Valencia, Spain
| | - Rosa Martí-Fernández
- Upper Gastrointestinal Surgery Unit, Hospital Clínico Universitario, Valencia, Spain.
| | | | | | - Fernando López-Mozos
- Upper Gastrointestinal Surgery Unit, Hospital Clínico Universitario, Valencia, Spain; Department of Surgery, Universidad de Valencia, Valencia, Spain
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Yoshinami Y, Nishimura E, Hosokai T, Yamamoto S, Matsuda S, Nomura M, Kawakubo H, Kato K, Kitagawa Y. Rare malignant neoplasm of the esophagus: current status and future perspectives. Jpn J Clin Oncol 2024; 54:111-120. [PMID: 37861097 PMCID: PMC10849183 DOI: 10.1093/jjco/hyad144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Abstract
Esophageal cancer is common worldwide, including in Japan, and its major histological subtype is squamous cell carcinoma. However, there are some rare esophageal cancers, including neuroendocrine neoplasm, gastrointestinal stromal tumor, carcinosarcoma and malignant melanoma. The biological and clinical features of these cancers differ from those of esophageal squamous cell carcinoma. Therefore, different treatment strategies are needed for these cancers but are based on limited evidence. Neuroendocrine neoplasm is mainly divided into neuroendocrine tumor and neuroendocrine carcinoma by differentiation and the Ki-67 proliferation index or mitotic index. Epidemiologically, the majority of esophageal neuroendocrine neoplasms are neuroendocrine carcinoma. The treatment of neuroendocrine carcinoma is similar to that of small cell lung cancer, which has similar morphological and biological features. Gastrointestinal stromal tumor is known to be associated with alterations in the c-KIT and platelet-derived growth factor receptor genes and, if resectable, is treated in accordance with the modified Fletcher classification. Carcinosarcoma is generally resistant to both chemotherapy and radiotherapy and requires multimodal treatments such as surgery plus chemotherapy to achieve cure. Primary malignant melanoma is resistant to cytotoxic chemotherapy, but immune checkpoint inhibitors have recently demonstrated efficacy for malignant melanoma of the esophagus. This review focuses on the current status and future perspectives for rare cancer of the esophagus.
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Affiliation(s)
- Yuri Yoshinami
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Erica Nishimura
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Taisuke Hosokai
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Shun Yamamoto
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Satoru Matsuda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Motoo Nomura
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Hirofumi Kawakubo
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ken Kato
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Abstract
Gastrointestinal stromal tumors (GISTs) are defined as mesenchymal tumors of the gastrointestinal tract that express positivity for CD117, which is a c-KIT proto-oncogene antigen. Expression of the c-KIT protein, a tyrosine kinase growth factor receptor, allows the distinction between GISTs and other mesenchymal tumors such as leiomyoma, leiomyosarcoma, schwannoma and neurofibroma. GISTs can develop anywhere in the gastrointestinal tract, as well as in the mesentery and omentum. Over the years, the management of GISTs has improved due to a better knowledge of their behaviors and risk or recurrence, the identification of specific mutations and the use of targeted therapies. This has resulted in a better prognosis for patients with GISTs. In parallel, imaging of GISTs has been revolutionized by tremendous progress in the field of detection, characterization, survival prediction and monitoring during therapy. Recently, a particular attention has been given to radiomics for the characterization of GISTs using analysis of quantitative imaging features. In addition, radiomics has currently many applications that are developed in conjunction with artificial intelligence with the aim of better characterizing GISTs and providing a more precise assessment of tumor burden. This article sums up recent advances in computed tomography and magnetic resonance imaging of GISTs in the field of image/data acquisition, tumor detection, tumor characterization, treatment response evaluation, and preoperative planning.
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Affiliation(s)
- Maxime Barat
- Department of Radiology, Hopital Cochin, Paris, France
- Université Paris Cité, Faculté de Médecine, Paris, France
| | - Anna Pellat
- Université Paris Cité, Faculté de Médecine, Paris, France
- Department of Gastroenterology and Digestive Oncology, Hôpital Cochin, Paris, France
| | - Anthony Dohan
- Department of Radiology, Hopital Cochin, Paris, France
- Université Paris Cité, Faculté de Médecine, Paris, France
| | - Christine Hoeffel
- Reims Medical School, Department of Radiology, Hopital Robert Debré, CHU Reims, Université Champagne-Ardennes, Reims, France
| | - Romain Coriat
- Université Paris Cité, Faculté de Médecine, Paris, France
- Department of Gastroenterology and Digestive Oncology, Hôpital Cochin, Paris, France
| | - Philippe Soyer
- Department of Radiology, Hopital Cochin, Paris, France
- Université Paris Cité, Faculté de Médecine, Paris, France
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Yoshinaga S. Endoscopic ultrasound-based application for determining the management of subepithelial lesions: Do androids dream of endoscopic ultrasound? Dig Endosc 2024; 36:152-153. [PMID: 37469303 DOI: 10.1111/den.14629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/30/2023] [Indexed: 07/21/2023]
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Deacu M, Bosoteanu M, Orășanu CI, Ursica OA, Voda RI. A 65-Year-Old Man Presenting to the Emergency Department with Gastric Hemorrhage Caused by a Glomus Tumor. Am J Case Rep 2024; 25:e942610. [PMID: 38185900 PMCID: PMC10788233 DOI: 10.12659/ajcr.942610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/07/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Glomus tumor is a benign but rapidly growing mesenchymal tumor that is a rare in the gastrointestinal tract, can be locally invasive due to its rapid growth, and can result in perforation of a viscus. We report a 65-year-old man presenting as an emergency with gastric hemorrhage and gastric glomus tumor. CASE REPORT A 65-year-old man came to our hospital for a life-threatening upper digestive hemorrhage. The preoperative examinations (digestive endoscopy without sampling of biopsy fragments and contrast-enhanced computer tomography) led to the presumptive diagnosis of gastrointestinal stromal tumor. Wedge resection of the gastric wall was performed. The histopathological examinations revealed a proliferation of round-oval cells of medium size with a solid disposition and in nests. This proliferation dissected the muscular tunic and caused ulceration of the gastric mucosa. Immunohistochemical tests confirmed the diagnosis of glomus tumor and excluded other diagnoses (neuroendocrine tumor or gastrointestinal stromal tumor). The postoperative evolution was favorable, and at the time of discharge, the biochemical test values normalized. CONCLUSIONS Pathologists are faced with a challenging task due to the deceptive appearance that can be presented by such a rare tumor. Histopathological and immunohistochemical examinations are essential in achieving a precise diagnosis and assessing the biological potential of the glomus tumor. Even if it is a benign tumor, the clinical picture it causes can still be a major risk to the patient's life. Consequently, ensuring effective case management becomes crucial, as it requires a thorough comprehension of all conditions encompassed in the differential diagnosis.
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Affiliation(s)
- Mariana Deacu
- Department of Pathology, Clinical Service of Pathology ”Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
| | - Madalina Bosoteanu
- Department of Pathology, Clinical Service of Pathology ”Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
| | - Cristian-Ionut Orășanu
- Department of Pathology, Clinical Service of Pathology ”Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, Constanta, Romania
| | - Oana Andreea Ursica
- Department of Pathology, Clinical Service of Pathology ”Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
| | - Raluca Ioana Voda
- Department of Pathology, Clinical Service of Pathology ”Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, Constanta, Romania
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Serrano C, Rothschild S, Villacampa G, Heinrich MC, George S, Blay JY, Sicklick JK, Schwartz GK, Rastogi S, Jones RL, Rutkowski P, Somaiah N, Navarro V, Evans D, Trent JC. Novel trial designs for patients with gastrointestinal stromal tumor. ESMO Open 2024; 9:102218. [PMID: 38194880 PMCID: PMC10837772 DOI: 10.1016/j.esmoop.2023.102218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/09/2023] [Indexed: 01/11/2024] Open
Affiliation(s)
- C Serrano
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona; Sarcoma Translational Research Program, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
| | | | - G Villacampa
- Oncology Data Science, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; The Institute of Cancer Research, London, UK
| | - M C Heinrich
- Portland VA Health Care System and Knight Cancer Institute, Oregon Health & Science University, Portland
| | - S George
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - J-Y Blay
- Department of Medical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon, France
| | - J K Sicklick
- Department of Surgery, Division of Surgical Oncology, University of California San Diego, San Diego; Department of Pharmacology, University of California San Diego, San Diego
| | - G K Schwartz
- Case Comprehensive Cancer Center, Cleveland, USA
| | - S Rastogi
- Department of Medical Oncology, AIIMS, New Delhi, India
| | - R L Jones
- The Royal Marsden NHS Foundation Trust, London; Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - N Somaiah
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - V Navarro
- Oncology Data Science, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - D Evans
- The Life Raft Group, Wayne, USA
| | - J C Trent
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, USA
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Gonzalez-Ballesteros P, de la Mora Levy JG, Amaya-Fragoso E, Sánchez Jíménez BA. The role of gastrointestinal endoscopy in Kaposi sarcoma. Rev Esp Enferm Dig 2023; 115:724-725. [PMID: 36866841 DOI: 10.17235/reed.2023.9534/2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
We are writing to make endoscopists aware of the paramount of a prompt diagnosis of gastrointestinal Kaposi sarcoma (GI-KS). Patients with GI involvement have a two to five times higher risk of death and will benefit from chemotherapy to improve their survival. However, current evidence found that one out of three patients might have a false negative result even with HHV-8 since other entities such as gastrointestinal stromal tumors, angiosarcoma, and lymphoma shared macroscopic and histopathological characteristics. These cause a delay in treatment and significantly worsen the prognosis. We observed a trend for a positive diagnosis from ulcers and nodules. To our knowledge, this is the largest cohort of patients with GI-KS in the world. Our study suggests that in cases where a complete immunochemistry panel for KS is not available, HHV-8 remains as a bare minimum. However, other gastrointestinal lesions shared histopathological characteristics. Therefore, we suggest taking biopsies from nodular and ulcer-type lesions to increase the probability to establish a histopathological diagnosis.
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van de Wal D, van Doorn B, den Hollander D, Desar IME, Gelderblom H, Oosten AW, Reyners AKL, Steeghs N, van der Graaf WTA, Husson O. The association of having a monitoring or blunting coping style with psychological distress, health-related quality of life and satisfaction with healthcare in gastrointestinal stromal tumour (GIST) patients. Acta Oncol 2023; 62:1616-1624. [PMID: 37856077 DOI: 10.1080/0284186x.2023.2269302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND There are two main coping styles regarding information seeking under medical threat; monitoring (information-seeking) and blunting (information-avoiding). The aim of this study is to (1) determine factors associated with a monitoring or blunting coping style in gastro-intestinal stromal tumour (GIST) patients and (2) investigate its association with psychological distress, cancer-related concerns, health-related quality of life and satisfaction with healthcare. METHODS In a cross-sectional study, Dutch GIST patients completed the shortened version of the Threatening Medical Situations Inventory to determine their coping style, the Hospital Anxiety and Depression Scale, Cancer Worry Scale, EORTC QLQ-C30 and part of the EORTC QLQ-INFO25. RESULTS A total of 307 patients were classified as blunters (n = 175, 57%) or monitors (n = 132, 43%). Coping style was not associated with tumour or treatment variables, but being a female (OR 2.5; 95%CI 1.5-4.1; p= <.001) and higher educated (OR 5.5; 95%CI 2.5-11.9, p= <.001) were associated with higher odds of being a monitor. Monitors scored significantly lower on emotional functioning (mean = 86.8 vs mean = 90.9, p=.044), which is considered a trivial difference, more often experienced severe fear of cancer recurrence or progression (53.0% vs 37.7%, p=.007), and had more concerns about dying from GIST in the future (60.6% vs 47.4%, p=.025). Compared to blunters, monitors were less satisfied with the received healthcare and information, and would have liked to receive more information. CONCLUSION GIST patients with a monitoring coping style experience a higher emotional burden. Additionally, monitors exhibit a greater need for information. Although this need for information could potentially result in fears and concerns, recognising it may also create an opening for tailored communication and information.
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Affiliation(s)
- Deborah van de Wal
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Britt van Doorn
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Dide den Hollander
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ingrid M E Desar
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Astrid W Oosten
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Anna K L Reyners
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Neeltje Steeghs
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Clinical Pharmacology, The Netherlands Cancer Institute, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Olga Husson
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, The Netherlands
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Zhu C, Hua Y, Zhang M, Wang Y, Li W, Ding Y, She Q, Zhang W, Si X, Kong Z, Liu B, Chen W, Wu J, Dang Y, Zhang G. A Multimodal Multipath Artificial Intelligence System for Diagnosing Gastric Protruded Lesions on Endoscopy and Endoscopic Ultrasonography Images. Clin Transl Gastroenterol 2023; 14:e00551. [PMID: 36434804 PMCID: PMC10584296 DOI: 10.14309/ctg.0000000000000551] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 11/11/2022] [Indexed: 10/20/2023] Open
Abstract
INTRODUCTION The aim of this study was to develop a novel artificial intelligence (AI) system that can automatically detect and classify protruded gastric lesions and help address the challenges of diagnostic accuracy and inter-reader variability encountered in routine diagnostic workflow. METHODS We analyzed data from 1,366 participants who underwent gastroscopy at Jiangsu Provincial People's Hospital and Yangzhou First People's Hospital between December 2010 and December 2020. These patients were diagnosed with submucosal tumors (SMTs) including gastric stromal tumors (GISTs), gastric leiomyomas (GILs), and gastric ectopic pancreas (GEP). We trained and validated a multimodal, multipath AI system (MMP-AI) using the data set. We assessed the diagnostic performance of the proposed AI system using the area under the receiver-operating characteristic curve (AUC) and compared its performance with that of endoscopists with more than 5 years of experience in endoscopic diagnosis. RESULTS In the ternary classification task among subtypes of SMTs using modality images, MMP-AI achieved the highest AUCs of 0.896, 0.890, and 0.999 for classifying GIST, GIL, and GEP, respectively. The performance of the model was verified using both external and internal longitudinal data sets. Compared with endoscopists, MMP-AI achieved higher recognition accuracy for SMTs. DISCUSSION We developed a system called MMP-AI to identify protruding benign gastric lesions. This system can be used not only for white-light endoscope image recognition but also for endoscopic ultrasonography image analysis.
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Affiliation(s)
- Chang Zhu
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yifei Hua
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Min Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yun Wang
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wenjie Li
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yanbing Ding
- Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Qiang She
- Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Weifeng Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinmin Si
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zihao Kong
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | | | | | | | - Yini Dang
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guoxin Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Meşină C, Obleagă CV, Ciorbagiu MC, Vere CC, Popescu DM, Popescu FC, Cristian DA, Meşină-Botoran MI. Solitary fibrous tumor developing in the right retroperitoneal space. Rom J Morphol Embryol 2023; 64:587-594. [PMID: 38184840 PMCID: PMC10863682 DOI: 10.47162/rjme.64.4.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024]
Abstract
Solitary fibrous tumor (SFT) is a rare mesenchymal tumor that is quite aggressive and prone to recurrence and metastasis. Most SFTs are benign, but the identification of the histological features that define the dedifferentiation of SFTs can predict the aggressiveness of the tumor and the presence of a reserved prognosis. We present a rare case of conventional SFTs with features of malignancy and highlight the diagnostic and therapeutic difficulties related to this case. Computed tomography aspect suggested a possible gastrointestinal stromal tumor. Surgical intervention was performed through median laparotomy and a tumor of approximately 15∕12 cm was found, developed from the level of the right retroperitoneal space, and pushing anteriorly the ascending colon, cecum, and terminal ileum. The immunohistochemical aspect correlated with the histopathological one suggests a SFT most likely malignant. In conclusion, the early diagnosis of SFTs is essential in establishing an appropriate treatment. Immunohistochemistry is indispensable in establishing the diagnosis of SFTs.
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Affiliation(s)
- Cristian Meşină
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania
- Department of Surgery, Emergency County Hospital, Craiova, Romania
| | - Cosmin Vasile Obleagă
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania
- Department of Surgery, Emergency County Hospital, Craiova, Romania
| | - Mihai Călin Ciorbagiu
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania
- Department of Surgery, Emergency County Hospital, Craiova, Romania
| | - Cristin Constantin Vere
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, Romania
- Department of Gastroenterology, Emergency County Hospital, Craiova, Romania
| | - Dragoş Marian Popescu
- Department of Extreme Conditions Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | | | - Daniel Alin Cristian
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Surgery, Colţea Clinical Hospital, Bucharest, Romania
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13
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Walter M. Quinlock® - neue Chancen bei GIST. MMW Fortschr Med 2023; 165:66. [PMID: 37710132 DOI: 10.1007/s15006-023-2968-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
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14
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Liao XL, Zhu YF, Zhang WH, Chen XL, Liu K, Zhao LY, Yang K, Hu JK. [Clinicopathological characteristics and prognosis of patients with small bowel tumors: A single center analysis of 220 cases]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:467-474. [PMID: 37217355 DOI: 10.3760/cma.j.cn441530-20230228-00057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Objective: To analyze the clinicopathological characteristics and prognosis of patients with small bowel tumors. Methods: This was a retrospective, observational study. We collected clinicopathological data of patients with primary jejunal or ileal tumors who had undergone small bowel resection in the Department of Gastrointestinal Surgery, West China Hospital, Sichuan University between January 2012 and September 2017. The inclusion criteria included: (1) older than 18 years; (2) had undergone small bowel resection; (3) primary location at jejunum or ileum; (4) postoperative pathological examination confirmed malignancy or malignant potential; and (5) complete clinicopathological and follow-up data. Patients with a history of previous or other concomitant malignancies and those who had undergone exploratory laparotomy with biopsy but no resection were excluded. The clinicopathological characteristics and prognoses of included patients were analyzed. Results: The study cohort comprised 220 patients with small bowel tumors, 136 of which were classified as gastrointestinal stromal tumors (GISTs), 47 as adenocarcinomas, and 35 as lymphomas. The median follow-up for all patient was 81.0 months (75.9-86.1). GISTs frequently manifested as gastrointestinal bleeding (61.0%, 83/136) and abdominal pain (38.2%, 52/136). In the patients with GISTs, the rates of lymph node and distant metastasis were 0.7% (1/136) and 11.8% (16/136), respectively. The median follow-up time was 81.0 (75.9-86.1) months. The 3-year overall survival (OS) rate was 96.3%. Multivariate Cox regression-analysis results showed that distant metastasis was the only factor associated with OS of patients with GISTs (HR=23.639, 95% CI: 4.564-122.430, P<0.001). The main clinical manifestations of small bowel adenocarcinoma were abdominal pain (85.1%, 40/47), constipation/diarrhea (61.7%, 29/47), and weight loss (61.7%, 29/47). Rates of lymph node and distant metastasis in patients with small bowel adenocarcinoma were 53.2% (25/47) and 23.4% (11/47), respectively. The 3-year OS rate of patients with small bowel adenocarcinoma was 44.7%. Multivariate Cox regression-analysis results showed that distant metastasis (HR=4.018, 95%CI: 2.108-10.331, P<0.001) and adjuvant chemotherapy (HR=0.291, 95% CI: 0.140-0.609, P=0.001) were independently associated with OS of patients with small bowel adenocarcinoma. Small bowel lymphoma frequently manifested as abdominal pain (68.6%, 24/35) and constipation/diarrhea (31.4%, 11/35); 77.1% (27/35) of small bowel lymphomas were of B-cell origin. The 3-year OS rate of patients with small bowel lymphomas was 60.0%. T/NK cell lymphomas (HR= 6.598, 95% CI: 2.172-20.041, P<0.001) and adjuvant chemotherapy (HR=0.119, 95% CI: 0.015-0.925, P=0.042) were independently associated with OS of patients with small bowel lymphoma. Small bowel GISTs have a better prognosis than small intestinal adenocarcinomas (P<0.001) or lymphomas (P<0.001), and small bowel lymphomas have a better prognosis than small bowel adenocarcinomas (P=0.035). Conclusions: The clinical manifestations of small intestinal tumor are non-specific. Small bowel GISTs are relatively indolent and have a good prognosis, whereas adenocarcinomas and lymphomas (especially T/NK-cell lymphomas) are highly malignant and have a poor prognosis. Adjuvant chemotherapy would likely improve the prognosis of patients with small bowel adenocarcinomas or lymphomas.
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Affiliation(s)
- X L Liao
- Laboratory of Gastric Cancer, Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Y F Zhu
- Laboratory of Gastric Cancer, Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - W H Zhang
- Laboratory of Gastric Cancer, Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - X L Chen
- Laboratory of Gastric Cancer, Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - K Liu
- Laboratory of Gastric Cancer, Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - L Y Zhao
- Laboratory of Gastric Cancer, Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - K Yang
- Laboratory of Gastric Cancer, Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - J K Hu
- Laboratory of Gastric Cancer, Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
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15
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Eberhardt J, Forli S. WaterKit: Thermodynamic Profiling of Protein Hydration Sites. J Chem Theory Comput 2023; 19:2535-2556. [PMID: 37094087 PMCID: PMC10732097 DOI: 10.1021/acs.jctc.2c01087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Water desolvation is one of the key components of the free energy of binding of small molecules to their receptors. Thus, understanding the energetic balance of solvation and desolvation resulting from individual water molecules can be crucial when estimating ligand binding, especially when evaluating different molecules and poses as done in High-Throughput Virtual Screening (HTVS). Over the most recent decades, several methods were developed to tackle this problem, ranging from fast approximate methods (usually empirical functions using either discrete atom-atom pairwise interactions or continuum solvent models) to more computationally expensive and accurate ones, mostly based on Molecular Dynamics (MD) simulations, such as Grid Inhomogeneous Solvation Theory (GIST) or Double Decoupling. On one hand, MD-based methods are prohibitive to use in HTVS to estimate the role of waters on the fly for each ligand. On the other hand, fast and approximate methods show an unsatisfactory level of accuracy, with low agreement with results obtained with the more expensive methods. Here we introduce WaterKit, a new grid-based sampling method with explicit water molecules to calculate thermodynamic properties using the GIST method. Our results show that the discrete placement of water molecules is successful in reproducing the position of crystallographic waters with very high accuracy, as well as providing thermodynamic estimates with accuracy comparable to more expensive MD simulations. Unlike these methods, WaterKit can be used to analyze specific regions on the protein surface, (such as the binding site of a receptor), without having to hydrate and simulate the whole receptor structure. The results show the feasibility of a general and fast method to compute thermodynamic properties of water molecules, making it well-suited to be integrated in high-throughput pipelines such as molecular docking.
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Affiliation(s)
- Jerome Eberhardt
- Department of Integrative Structural and Computational Biology, Scripps Research, La Jolla, California 92037, United States
| | - Stefano Forli
- Department of Integrative Structural and Computational Biology, Scripps Research, La Jolla, California 92037, United States
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16
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Yang J, Trivedi A, Nyirenda T, Shi M, Petit R, Talishinskiy T. Histopathologic findings in laparoscopic sleeve gastrectomy: is routine full pathologic evaluation indicated? Surg Obes Relat Dis 2023; 19:283-288. [PMID: 36372693 DOI: 10.1016/j.soard.2022.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/07/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Laparoscopic sleeve gastrectomy (SG) is the most commonly performed bariatric surgery. The resected gastric segment is routinely sent for pathology evaluation. No formal national recommendation exists that mandates pathology review. We proposed to study the largest histopathologic series in SG patients yet reported. OBJECTIVE The primary objective of our study was to determine whether a subgroup of patients who underwent bariatric surgery in the northeastern Unites States is more susceptible to having clinically significant pathologic findings that may benefit from routine histopathologic evaluation of the gastric sleeve specimen. SETTING University hospital. METHODS A retrospective electronic chart review of patients who underwent SG at a single large academic institution was performed. Patient demographics, body mass index, and histopathologic reports of the gastric specimens obtained during SG were analyzed. RESULTS The records of 3543 patients were reviewed. A total of 1076 patients had abnormal pathologies, including gastritis (938), follicular gastritis (98), intestinal metaplasia (25), gastrointestinal stromal tumor (12), leiomyoma (1), lymphoma (1), and other malignancy (1). Black and Hispanic patients had a higher incidence of developing gastrointestinal stromal tumor and intestinal metaplasia. A higher incidence of Helicobacter pylori infection among specimens with abnormal pathologies was noted. CONCLUSIONS The findings of this study call into question the routine use of pathology workup in gastric specimens after SG. Our data suggest that such analysis may be warranted in certain subtypes of patients such as older Black and Hispanic patients in the northeastern United States.
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Affiliation(s)
- James Yang
- St. Joseph's University Medical Center, Paterson, New Jersey.
| | - Aakash Trivedi
- St. Joseph's University Medical Center, Paterson, New Jersey
| | - Themba Nyirenda
- Hackensack University Medical Center, Hackensack, New Jersey
| | - Meiyi Shi
- Hackensack University Medical Center, Hackensack, New Jersey
| | - Ryan Petit
- Hackensack University Medical Center, Hackensack, New Jersey
| | - Toghrul Talishinskiy
- St. Joseph's University Medical Center, Paterson, New Jersey; Hackensack University Medical Center, Hackensack, New Jersey
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17
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Carter BM, Bronsert MR, Wilky BA, McCarter MD. Mucosal Ulceration in Gastrointestinal Stromal Tumor is an Independent Predictor of Progression-Free Survival. J Surg Res 2023; 284:221-229. [PMID: 36587482 DOI: 10.1016/j.jss.2022.11.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 11/12/2022] [Accepted: 11/20/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal (GI) tract. Known prognostic features of GISTs include tumor mitotic rate, size, and location, yet one common feature of primary GISTs for which prognostic significance is unknown, is mucosal ulceration. This study aims to investigate the significance of mucosal ulceration in GISTs. MATERIALS AND METHODS A retrospective study was conducted of 513 patients at a tertiary referral center with a suspected or documented diagnosis of primary GIST between the years of 2000 and 2020. Ulceration was confirmed by definitive documentation in the endoscopic or histopathologic report. The significance of ulceration in GIST was compared to other prognostic factors. RESULTS Of the 513 patients reviewed, 310 primary GIST patients with known ulceration and disease status were identified. Of those, 27.4% (n = 85) demonstrated mucosal ulceration. Mucosal ulceration in GISTs is associated with GI bleeding, mitotic rate, tumor size, and exon 11 mutations. After a median follow-up of 35.4 (interquartile range = 17.1-62.2) mo, patients with ulcerated GISTs experienced higher rates of tumor progression (40.0% versus 14.2%, P < 0.0001). In multivariate analysis, ulceration of GISTs was highly associated with disease progression (P < 0.0001) and progression-free survival (hazard ratio = 2.4 [1.2-4.7], P = 0.01). CONCLUSIONS Mucosal ulceration in GISTs is associated with GI bleeding, mitotic rate, tumor size, and exon 11 mutations. Overall, ulceration in GISTs is associated with elevated risk of tumor progression and is an independent prognostic factor. In multivariate analysis, ulceration in GIST remains an independent risk factor for disease progression.
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Affiliation(s)
- Brian M Carter
- University of Colorado School of Medicine, Aurora, Colorado
| | - Michael R Bronsert
- Surgical Outcomes and Applied Research (SOAR), University of Colorado, Aurora, Colorado
| | - Breelyn A Wilky
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Martin D McCarter
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Aurora, Colorado.
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Dirkson A, Verberne S, van Oortmerssen G, Gelderblom H, Kraaij W. How do others cope? Extracting coping strategies for adverse drug events from social media. J Biomed Inform 2023; 139:104228. [PMID: 36309197 DOI: 10.1016/j.jbi.2022.104228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/09/2022] [Accepted: 10/09/2022] [Indexed: 02/16/2023]
Abstract
Patients advise their peers on how to cope with their illness in daily life on online support groups. To date, no efforts have been made to automatically extract recommended coping strategies from online patient discussion groups. We introduce this new task, which poses a number of challenges including complex, long entities, a large long-tailed label space, and cross-document relations. We present an initial ontology for coping strategies as a starting point for future research on coping strategies, and the first end-to-end pipeline for extracting coping strategies for side effects. We also compared two possible computational solutions for this novel and highly challenging task; multi-label classification and named entity recognition (NER) with entity linking (EL). We evaluated our methods on the discussion forum from the Facebook group of the worldwide patient support organization 'GIST support international' (GSI); GIST support international donated the data to us. We found that coping strategy extraction is difficult and both methods attain limited performance (measured with F1 score) on held out test sets; multi-label classification outperforms NER+EL (F1=0.220 vs F1=0.155). An inspection of the multi-label classification output revealed that for some of the incorrect predictions, the reference label is close to the predicted label in the ontology (e.g. the predicted label 'juice' instead of the more specific reference label 'grapefruit juice'). Performance increased to F1=0.498 when we evaluated at a coarser level of the ontology. We conclude that our pipeline can be used in a semi-automatic setting, in interaction with domain experts to discover coping strategies for side effects from a patient forum. For example, we found that patients recommend ginger tea for nausea and magnesium and potassium supplements for cramps. This information can be used as input for patient surveys or clinical studies.
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Affiliation(s)
- Anne Dirkson
- Leiden Institute of Advanced Computer Science, Leiden University, Niels Bohrweg 1, 2333 CA Leiden, Netherlands.
| | - Suzan Verberne
- Leiden Institute of Advanced Computer Science, Leiden University, Niels Bohrweg 1, 2333 CA Leiden, Netherlands.
| | - Gerard van Oortmerssen
- Leiden Institute of Advanced Computer Science, Leiden University, Niels Bohrweg 1, 2333 CA Leiden, Netherlands.
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, Netherlands.
| | - Wessel Kraaij
- Leiden Institute of Advanced Computer Science, Leiden University, Niels Bohrweg 1, 2333 CA Leiden, Netherlands.
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Huang CY, Lee JC, Liang CW, Lee YH. A wolf in sheep's clothing: A microscopic gastrointestinal stromal tumor arising in gastric leiomyoma. Pathol Int 2023; 73:135-137. [PMID: 36575954 DOI: 10.1111/pin.13301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/01/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Chung-Yen Huang
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jen-Chieh Lee
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Cher-Wei Liang
- Department of Pathology, Fu Jen Catholic University Hospital, New Taipei, Taiwan
| | - Yi-Hsuan Lee
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
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Radu P, Zurzu M, Paic V, Bratucu M, Garofil D, Tigora A, Georgescu V, Prunoiu V, Popa F, Surlin V, Strambu V. Interstitial Cells of Cajal-Origin, Distribution and Relationship with Gastrointestinal Tumors. Medicina (Kaunas) 2022; 59:medicina59010063. [PMID: 36676686 PMCID: PMC9865743 DOI: 10.3390/medicina59010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 12/29/2022]
Abstract
The interstitial cells of Cajal (ICC) represent a particular network formed by some peculiar cells that were first described by the great neuroanatomist, S. Ramon y Cajal. Nowadays, the ICC have become a fascinating topic for scientists, arousing their curiosity; as a result, there is a vast number of published articles related to the ICC. Today, everybody widely accepts that the ICC represent the pacemaker of the gastrointestinal tract and are highly probable to be the origin cells for gastrointestinal tumors (GISTs). Recently, Cajal-like cells (ICLC) were described, which are found in different organs but with an as yet unknown physiological role that needs further study. New information regarding intestinal development indicates that the ICC (fibroblast-like and muscle-like) and intestinal muscle cells have the same common embryonic cells, thereby presenting the same cellular ultrastructure. Nowadays, there is a vast quantity of information that proves the connection of the ICC and GISTs. Both of them are known to present c-kit expression and the same ultrastructural cell features, which includes minimal myoid differentiation that is noticed in GISTs, therefore, supporting the hypothesis that GISTs are ICC-related tumors. In this review, we have tried to highlight the origin and distribution of Cajal interstitial cells based on their ultrastructural features as well as their relationship with gastrointestinal stromal tumors.
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Affiliation(s)
- Petru Radu
- General Surgery Department, Carol Davila Nephrology Hospital Bucharest, 020021 Bucharest, Romania
| | - Mihai Zurzu
- General Surgery Department, Carol Davila Nephrology Hospital Bucharest, 020021 Bucharest, Romania
- Correspondence:
| | - Vlad Paic
- General Surgery Department, Carol Davila Nephrology Hospital Bucharest, 020021 Bucharest, Romania
| | - Mircea Bratucu
- General Surgery Department, Carol Davila Nephrology Hospital Bucharest, 020021 Bucharest, Romania
| | - Dragos Garofil
- General Surgery Department, Carol Davila Nephrology Hospital Bucharest, 020021 Bucharest, Romania
| | - Anca Tigora
- General Surgery Department, Carol Davila Nephrology Hospital Bucharest, 020021 Bucharest, Romania
| | - Valentin Georgescu
- General Surgery Department, Carol Davila Nephrology Hospital Bucharest, 020021 Bucharest, Romania
| | - Virgiliu Prunoiu
- Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Florian Popa
- General Surgery Department, Carol Davila Nephrology Hospital Bucharest, 020021 Bucharest, Romania
| | - Valeriu Surlin
- Sixth Department of Surgery, University of Medicine and Pharmacy of Craiova, Craiova Emergency Clinical Hospital, 200642 Craiova, Romania
| | - Victor Strambu
- General Surgery Department, Carol Davila Nephrology Hospital Bucharest, 020021 Bucharest, Romania
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Schöffski P, George S, Heinrich MC, Zalcberg JR, Bauer S, Gelderblom H, Serrano C, Jones RL, Attia S, D'Amato G, Chi P, Reichardt P, Becker C, Shi K, Meade J, Ruiz-Soto R, Blay JY, von Mehren M. Patient-reported outcomes in individuals with advanced gastrointestinal stromal tumor treated with ripretinib in the fourth-line setting: analysis from the phase 3 INVICTUS trial. BMC Cancer 2022; 22:1302. [PMID: 36514034 PMCID: PMC9746146 DOI: 10.1186/s12885-022-10379-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Ripretinib is a novel switch-control kinase inhibitor that inhibits KIT and PDGFRA signaling. In the INVICTUS phase 3 trial, ripretinib increased median progression-free survival and prolonged overall survival vs. placebo in ≥ fourth-line advanced GIST. Here, we report prespecified analysis of quality of life (QoL) as assessed by patient-reported outcome (PRO) measures and an exploratory analysis evaluating the impact of alopecia on QoL. METHODS In the INVICTUS trial (NCT03353753), QoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30; physical function, role function, overall health, and overall QoL) and the EuroQoL 5-Dimension 5-Level (EQ-5D-5 L; visual analogue scale). Analysis of covariance (ANCOVA) models compared changes in scores from baseline to treatment cycle 2, day 1 within and between ripretinib and placebo. Within the ripretinib arm, repeated measures models assessed the impact of alopecia on QoL. RESULTS Patients receiving ripretinib maintained QoL (as assessed by the EORTC QLQ-C30 and EQ-5D-5 L PRO measures) from baseline to cycle 2, day 1 whereas QoL declined with placebo, resulting in clinically significant differences between treatments (nominal P < 0.01). The most common treatment-emergent adverse event with ripretinib was alopecia; however, QoL was similarly maintained out to treatment cycle 10, day 1 in patients receiving ripretinib who developed alopecia and those who did not. CONCLUSION PRO assessments in the INVICTUS trial suggest that patients on ripretinib maintain their QoL out to C2D1, unlike patients receiving placebo. Longitudinal QoL was maintained for patients receiving ripretinib out to cycle 10, day 1 (approximately 8 months; past the point of median progression-free survival with ripretinib [6.3 months]), even if the patients developed alopecia. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03353753 ; first posted: November 27, 2017.
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Affiliation(s)
- Patrick Schöffski
- General Medical Oncology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.
| | - Suzanne George
- Dana-Farber Cancer Institute, 450 Brookline Ave, 02215, Boston, MA, USA
| | - Michael C Heinrich
- VA Portland Veterans Health Care System, 3710 SW US Veterans Hospital Rd., 97239, Portland, OR, USA
- OHSU Knight Cancer Institute, 3161 SW Pavilion Loop, 97239, Portland, OR, USA
| | - John R Zalcberg
- Monash University and Alfred Health, 553 St Kilda Road, VIC, 3004, Melbourne, Australia
| | - Sebastian Bauer
- Department of Medical Oncology, University Hospital Essen, Sarcoma Center/West German Cancer Center, University Duisburg-Essen, Hufelandstraße 55, D - 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner site University Hospital Essen, Essen, Germany
| | - Hans Gelderblom
- Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, Netherlands
| | - César Serrano
- Centro Cellex, Vall d'Hebron Institute of Oncology, Carrer de Natzaret, 115-117, 08035, Barcelona, Spain
| | - Robin L Jones
- Royal Marsden and Institute of Cancer Research, 15 Cotswold Rd, SM2 5NG, London, UK
| | - Steven Attia
- Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA
| | - Gina D'Amato
- Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave, 33136, Miami, FL, USA
| | - Ping Chi
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, 10065, New York, NY, USA
| | - Peter Reichardt
- Sarcoma Center, Helios Klinikum Berlin-Buch, Schwanebecker Ch 50, 13125, Berlin, Germany
| | - Claus Becker
- Deciphera Pharmaceuticals, LLC, 200 Smith St., 02451, Waltham, MA, USA
| | - Kelvin Shi
- Deciphera Pharmaceuticals, LLC, 200 Smith St., 02451, Waltham, MA, USA
| | - Julie Meade
- Deciphera Pharmaceuticals, LLC, 200 Smith St., 02451, Waltham, MA, USA
| | - Rodrigo Ruiz-Soto
- Deciphera Pharmaceuticals, LLC, 200 Smith St., 02451, Waltham, MA, USA
| | - Jean-Yves Blay
- Centre Leon Berard, 28 Prom. Léa et Napoléon Bullukian, 69008, Lyon, France
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IJzerman NS, van Werkhoven E, Mohammadi M, Hollander DD, Bleckman RF, Reyners AKL, Desar IME, Gelderblom H, Grünhagen DJ, Mathijssen RHJ, Steeghs N, van der Graaf WTA. Sex differences in patients with gastrointestinal stromal tumours: do they exist and does it affect survival? ESMO Open 2022; 7:100649. [PMID: 36493601 PMCID: PMC9808455 DOI: 10.1016/j.esmoop.2022.100649] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/20/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sex differences in cancer have gained attention in recent years. The role of sex as a prognostic factor in gastrointestinal stromal tumours (GIST) has not been well established. The aim of this research was to elucidate potential sex differences in GIST patients and the influence of sex on disease-specific survival (DSS). METHODS A review of the literature was carried out to obtain an overview of all literature with sex as a covariate on GIST survival analyses. Furthermore, in the Dutch GIST Registry, GIST characteristics between males and females were compared and the influence of sex on DSS was analysed. RESULTS A total of 118 articles from the review of the literature met our selection criteria; 58% of the articles found no sex difference in survival and 42% did find a sex difference. All differences favoured female patients, although there was substantial overlap of individual patients in the various reported groups. The Dutch GIST Registry cohort consisted of 1425 patients (46% female). Compared with female patients, male patients had larger tumours (mean 9.0 cm versus 7.9 cm) and higher mitotic rates (34.4% versus 28.0% >5 mitoses/5 mm2). GIST in males was more often metastasized at diagnosis (21.3% versus 13.7%) and incurable (38.5% versus 31.0%). Male patients less often received surgery of the primary tumour (71.7% versus 78.9%), but did experience more tumour ruptures (18.2% versus 13.3%). Male patients had a worse DSS than females. This was not statistically significant when corrected for differences in GIST characteristics. CONCLUSIONS In case of sex differences in GIST in the literature, male patients have a worse outcome. In our Dutch GIST cohort a similar finding was made, but sex was shown not to be an independent factor. Male patients more often had aggressive GISTs, with larger tumours, higher mitotic rates, more tumour ruptures, and metastases, which could explain the sex differences in DSS.
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Affiliation(s)
- N S IJzerman
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - E van Werkhoven
- Department of Hematology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M Mohammadi
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - D den Hollander
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - R F Bleckman
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - A K L Reyners
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - I M E Desar
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - D J Grünhagen
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - R H J Mathijssen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - N Steeghs
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - W T A van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands.
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23
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Li Z, Zhang D, Mo C, Zhu P, Fan X, Tang T. The prognostic significance of prognostic nutritional index in gastrointestinal stromal tumors: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e32067. [PMID: 36451460 PMCID: PMC9704956 DOI: 10.1097/md.0000000000032067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Risk assessment before treatment is important for gastrointestinal stromal tumors (GISTs), which will determine the priority of surgery or preoperative treatment. The prognostic nutritional index (PNI) is an integrated parameter consisting of serum albumin and lymphocyte count. Immunonutritional status defined in this manner is well-known to be closely linked to the prognosis of several other cancers. Nevertheless, the prognostic value of PNI specifically in GISTs has not been well-established. This study aimed to verify the prognostic role of PNI in patients with GISTs. METHODS A comprehensive literature search was conducted on medical databases up to June, 2022, and the raw data (hazard ratios and 95% confidence intervals [CIs]) focusing on the prognostic value of PNI in patients with GISTs regarding recurrence-free survival were extracted and synthesized adopting the random-effects model. This review was registered in the PROSPERO database (CRD42022345440). RESULTS A total of 8 eligible studies including 2627 patients with GISTs was analyzed and the pooled results confirmed that an elevated PNI was associated with a better recurrence-free survival (hazard ratio: 0.52, 95% CI: 0.40-0.68), with a moderate heterogeneity (I-square, 38%). The findings from subgroup analysis were consistent with the overall pooled results, and a sensitivity analysis, not the subgroup analysis, identified the source of heterogeneity. CONCLUSION Elevated pretreatment PNI may be a useful indicator for assessing risk of recurrence in patients from China with GISTs. Studies in other countries and regions are needed to further verify the prognostic value of PNI in GISTs.
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Affiliation(s)
- Zhenjie Li
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
| | - Dengming Zhang
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
| | - Chunlin Mo
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
| | - Peijin Zhu
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
| | - Xiaoxi Fan
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
| | - Tingyong Tang
- Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan, Guangdong Province, China
- Department of General Surgery, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, China
- * Correspondence: Tingyong Tang, Department of General Surgery, Sanshui Hospital affiliated to Guangdong Medical College, Foshan 528100, China (e-mail: )
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24
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Bravo-Taxa M, Luque Vásquez-Vásquez C, Ruiz-Figueroa E, Taxa-Rojas L. [Ectopic hepatocellular carcinoma. A case report]. Rev Esp Patol 2022; 55:282-287. [PMID: 36154738 DOI: 10.1016/j.patol.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/08/2021] [Accepted: 02/21/2021] [Indexed: 06/16/2023]
Abstract
Ectopic liver (EL) is a rare developmental anomaly caused by the migration of hepatic cells to other locations during embryogenesis. Its incidence is thought to be between 0.24 and 0.47% and can occur in various sites, although the gall bladder is the most frequent. Approximately 100 cases of EL have been published, of which 28 developed hepatocellular carcinoma, whilst the orthotopic liver was unaffected. All cases are reported in Asian and Caucasian patients. We report the case of a 42-year-old patient with a solid lesion measuring 17×12×12cm apparently arising from the posterior wall of the stomach, displacing various organs and suggestive of a gastrointestinal stromal tumour (GIST). The liver, biliary tract and other structures were unremarkable. Histopathology revealed a diagnosis of hepatocellular carcinoma in ectopic liver tissue.
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Affiliation(s)
| | | | - Eloy Ruiz-Figueroa
- Departamento de Abdomen, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
| | - Luis Taxa-Rojas
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú; Laboratorio Oncológico Taxa, Lima, Perú
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25
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Bravo-Taxa M, Luque Vásquez-Vásquez C, Guerrero-Quiroga M, Taxa-Rojas L. [Colloid Carcinoma of the pancreas and synchronous gastrointestinal stromal tumour of stomach. A case report and review of the literature]. Rev Esp Patol 2022; 55:259-266. [PMID: 36154734 DOI: 10.1016/j.patol.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/07/2021] [Accepted: 02/20/2021] [Indexed: 06/16/2023]
Abstract
Colloid carcinoma (CC) is a rare histological type of adenocarcinoma of the pancreatic duct and is characterized by the presence of large lakes of extracellular mucin containing neoplastic cells. Its 5 year prognosis is more favourable than that of ductal, tubular or not otherwise specified (NOS) adenocarcinomas. We present the case of a 74-year-old woman with a thin walled, multicystic lesion in the tail of the pancreas, radiologically suggestive of a serous cystadenoma as opposed to a mucinous neoplasm. Surgery revealed a 10 x 6 cm lesion invading the splenic hilum and transverse mesocolon. Two nodes on the wall of the gastric fundus were also removed. Histopathology showed the pancreatic tumour to be a colloid carcinoma with a synchronous gastrointestinal stromal tumour of the gastric fundus.
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Affiliation(s)
- Mercedes Bravo-Taxa
- Patología Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú.
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26
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Chang T, Sa T, Yu M, Zhang B, Lyu Z. Gas-containing mesenteric desmoid-type fibromatosis: A case report. Medicine (Baltimore) 2022; 101:e30326. [PMID: 36086779 PMCID: PMC10980479 DOI: 10.1097/md.0000000000030326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/15/2022] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Desmoid-type fibromatosis is a rare benign mesenchymal neoplasm. Only 8% of desmoid-type fibromatosis develops in the abdominal cavity. The mesentery is seldom affected and gastrointestinal stromal tumors need to be considered in the differential diagnosis, particularly when imaging examination shows a tumor containing gases in the abdominal cavity. Only a few cases of gas-containing mesenteric desmoid-type fibromatosis have been reported in the literature. PATIENT CONCERNS A 69-year-old male patient presented with hematochezia and intermittent upper abdominal pain. DIAGNOSIS Contrast-enhanced computed tomography revealed a 3.9 × 3.6 cm gas-containing mass infiltrating the third portion of the duodenum. The tumor was heterogeneous, with cysts and air bubbles. It showed heterogeneous weak-to-mild enhancement in the solid part. Postoperative pathological examination confirmed a final diagnosis of mesenteric desmoid-type fibromatosis. INTERVENTIONS The patient underwent surgical resection of intra-abdominal lesion. OUTCOMES No evidence of local recurrence was noted during the 6 months of follow-up. LESSONS Accurate preoperative diagnosis is difficult for an intra-abdominal gas-containing mass on computed tomography scan. The appearance of spiculated infiltrative margin suggests the diagnosis of desmoid-type fibromatosis. Further investigation of imaging evidence and treatment methods is necessary.
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Affiliation(s)
- Tianjing Chang
- Department of Radiology, Shougang Hospital, Peking University, Beijing, China
| | - Tang Sa
- Pathology Department, Shougang Hospital, Peking University, Beijing, China
| | - Mingchuan Yu
- Department of Radiology, Shougang Hospital, Peking University, Beijing, China
| | - Bin Zhang
- Department of Radiology, Shougang Hospital, Peking University, Beijing, China
| | - Zhe Lyu
- Department of Radiology, Shougang Hospital, Peking University, Beijing, China
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27
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Zhao Z, Yin XN, Wang J, Chen X, Cai ZL, Zhang B. Prognostic significance of hemoglobin, albumin, lymphocyte, platelet in gastrointestinal stromal tumors: A propensity matched retrospective cohort study. World J Gastroenterol 2022; 28:3476-3487. [PMID: 36158264 PMCID: PMC9346454 DOI: 10.3748/wjg.v28.i27.3476] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/19/2022] [Accepted: 06/19/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The combined index of hemoglobin, albumin, lymphocyte, and platelet (HALP) can reflect systemic inflammation and nutritional status simultaneously, with some evidence revealing its prognostic value for some tumors. However, the effect of HALP on recurrence-free survival (RFS) in patients with gastrointestinal stromal tumors (GISTs) has not been reported.
AIM To investigate the prognostic value of HALP in GIST patients.
METHODS Data from 591 untreated patients who underwent R0 resection for primary and localized GISTs at West China Hospital between December 2008 and December 2016 were included. Clinicopathological data, preoperative albumin, blood routine information, postoperative treatment, and recurrence status were recorded. To eliminate baseline inequivalence, the propensity scores matching (PSM) method was introduced. Ultimately, the relationship between RFS and preoperative HALP was investigated.
RESULTS The optimal cutoff value for HALP was determined to be 31.5 by X-tile analysis. HALP was significantly associated with tumor site, tumor size, mitosis, Ki67, National Institutes of Health (NIH) risk category, and adjuvant therapy (all P < 0.001). Before PSM, GIST patients with an increased HALP had a significantly poor RFS (P < 0.001), and low HALP was an independent risk factor for poor RFS [hazard ratio (HR): 0.506, 95% confidence interval (95%CI): 0.291-0.879, P = 0.016]. In NIH high-risk GIST patients, GIST patients with low HALP had a worse RFS than patients with high HALP (P < 0.05). After PSM, 458 GIST patients were identified; those with an increased HALP still had significantly poor RFS after PSM (P < 0.001) and low HALP was still an independent risk factor for poor RFS (HR: 0.558, 95%CI: 0.319-0.976, P = 0.041).
CONCLUSION HALP was significantly correlated with postoperative pathology and postoperative treatment. Furthermore, HALP showed a strong ability to predict RFS in GIST patients who underwent radical resection.
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Affiliation(s)
- Zhou Zhao
- Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu 610041, Sichuan Province, China
| | - Xiao-Nan Yin
- Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu 610041, Sichuan Province, China
| | - Jian Wang
- Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu 610041, Sichuan Province, China
| | - Xin Chen
- Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu 610041, Sichuan Province, China
| | - Zhao-Lun Cai
- Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu 610041, Sichuan Province, China
| | - Bo Zhang
- Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu 610041, Sichuan Province, China
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28
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Richards E, Jennings T, Heymann WR, Introcaso CE. Acquired Lymphangiectasia in the Setting of a Gastrointestinal Stromal Tumor. Skinmed 2022; 20:210-211. [PMID: 35779027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 53-year-old woman presented for a skin cancer screening and was found to have scattered violaceous papulovesicles on the right buttock and right lower aspect of the abdomen. These lesions had been increasing in number for 3 years. The patient denied pain or pruritis at the site of lesions and denied any systemic fi ndings.
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Affiliation(s)
- Elizabeth Richards
- Division of Dermatology, Department of Medicine, Cooper Medical School of Rowan University, Camden, NJ
| | - Tara Jennings
- Department of Medicine, Division of Dermatology, Cooper University Hospital, Camden, NJ
| | - Warren R Heymann
- Division of Dermatology, Department of Medicine, Cooper Medical School of Rowan University, Camden, NJ
- Department of Medicine, Division of Dermatology, Cooper University Hospital, Camden, NJ
| | - Camille E Introcaso
- Division of Dermatology, Department of Medicine, Cooper Medical School of Rowan University, Camden, NJ
- Department of Medicine, Division of Dermatology, Cooper University Hospital, Camden, NJ;
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29
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Janku F, Bauer S, Shoumariyeh K, Jones RL, Spreafico A, Jennings J, Psoinos C, Meade J, Ruiz-Soto R, Chi P. Efficacy and safety of ripretinib in patients with KIT-altered metastatic melanoma. ESMO Open 2022; 7:100520. [PMID: 35753087 PMCID: PMC9434165 DOI: 10.1016/j.esmoop.2022.100520] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/25/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Ripretinib, a broad-spectrum KIT and platelet-derived growth factor receptor A switch-control tyrosine kinase inhibitor, is approved for the treatment of adult patients with advanced gastrointestinal stromal tumor as ≥ fourth-line therapy. We present the efficacy and safety of ripretinib in patients with KIT-altered metastatic melanoma enrolled in the expansion phase of the ripretinib phase I study. PATIENTS AND METHODS Patients with KIT-altered metastatic melanoma were enrolled and treated with ripretinib at the recommended phase II dose of 150 mg once daily in 28-day cycles. Investigator-assessed responses according to Response Evaluation Criteria In Solid Tumors version 1.1 were carried out on day 1 of cycles 3, 5, 7, every three cycles thereafter, and at a final study visit. RESULTS A total of 26 patients with KIT-altered metastatic melanoma (25 with KIT mutations, 1 with KIT-amplification) were enrolled. Patients had received prior immunotherapy (n = 23, 88%) and KIT inhibitor therapy (n = 9, 35%). Confirmed objective response rate (ORR) was 23% [95% confidence interval (CI) 9%-44%; one complete and five partial responses] with a median duration of response of 9.1 months (range, 6.9-31.3 months). Median progression-free survival (mPFS) was 7.3 months (95% CI 1.9-13.6 months). Patients without prior KIT inhibitor therapy had a higher ORR and longer mPFS (n = 17, ORR 29%, mPFS 10.2 months) than those who had received prior KIT inhibitor treatment (n = 9, ORR 11%, mPFS 2.9 months). The most common treatment-related treatment-emergent adverse events (TEAEs) of any grade in ≥15% of patients were increased lipase, alopecia, actinic keratosis, myalgia, arthralgia, decreased appetite, fatigue, hyperkeratosis, nausea, and palmar-plantar erythrodysesthesia syndrome. There were no grade ≥4 treatment-related TEAEs. CONCLUSIONS In this phase I study, ripretinib demonstrated encouraging efficacy and a well-tolerated safety profile in patients with KIT-altered metastatic melanoma, suggesting ripretinib may have a clinically meaningful role in treating these patients.
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Affiliation(s)
- F Janku
- Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA.
| | - S Bauer
- Department of Medical Oncology, Sarcoma Center/West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - K Shoumariyeh
- Department of Medicine I, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - R L Jones
- Medical Oncology, Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - A Spreafico
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, and Department of Medicine, University of Toronto, Toronto, Canada
| | - J Jennings
- Deciphera Pharmaceuticals, LLC, Waltham, USA
| | - C Psoinos
- Deciphera Pharmaceuticals, LLC, Waltham, USA
| | - J Meade
- Deciphera Pharmaceuticals, LLC, Waltham, USA
| | - R Ruiz-Soto
- Deciphera Pharmaceuticals, LLC, Waltham, USA
| | - P Chi
- Human Oncology and Pathogenesis Program/Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
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30
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Zhang H, Qian F, Shang F, Du W, Qian J, Yang J. Global Convergence Guarantees of (A)GIST for a Family of Nonconvex Sparse Learning Problems. IEEE Trans Cybern 2022; 52:3276-3288. [PMID: 32784147 DOI: 10.1109/tcyb.2020.3010960] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In recent years, most of the studies have shown that the generalized iterated shrinkage thresholdings (GISTs) have become the commonly used first-order optimization algorithms in sparse learning problems. The nonconvex relaxations of the l0 -norm usually achieve better performance than the convex case (e.g., l1 -norm) since the former can achieve a nearly unbiased solver. To increase the calculation efficiency, this work further provides an accelerated GIST version, that is, AGIST, through the extrapolation-based acceleration technique, which can contribute to reduce the number of iterations when solving a family of nonconvex sparse learning problems. Besides, we present the algorithmic analysis, including both local and global convergence guarantees, as well as other intermediate results for the GIST and AGIST, denoted as (A)GIST, by virtue of the Kurdyka-Łojasiewica (KŁ) property and some milder assumptions. Numerical experiments on both synthetic data and real-world databases can demonstrate that the convergence results of objective function accord to the theoretical properties and nonconvex sparse learning methods can achieve superior performance over some convex ones.
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31
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Williams ST, Chatzikyriakou P, Carroll PV, McGowan BM, Velusamy A, White G, Obholzer R, Akker S, Tufton N, Casey RT, Maher ER, Park SM, Porteous M, Dyer R, Tan T, Wernig F, Brady AF, Kosicka-Slawinska M, Whitelaw BC, Dorkins H, Lalloo F, Brennan P, Carlow J, Martin R, Mitchell AL, Harrison R, Hawkes L, Newell-Price J, Kelsall A, Igbokwe R, Adlard J, Schirwani S, Davidson R, Morrison PJ, Chung TT, Bowles C, Izatt L. SDHC phaeochromocytoma and paraganglioma: A UK-wide case series. Clin Endocrinol (Oxf) 2022; 96:499-512. [PMID: 34558728 DOI: 10.1111/cen.14594] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/04/2021] [Accepted: 08/15/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Phaeochromocytomas and paragangliomas (PPGL) are rare, but strongly heritable tumours. Variants in succinate dehydrogenase (SDH) subunits are identified in approximately 25% of cases. However, clinical and genetic information of patients with SDHC variants are underreported. DESIGN This retrospective case series collated data from 18 UK Genetics and Endocrinology departments. PATIENTS Both asymptomatic and disease-affected patients with confirmed SDHC germline variants are included. MEASUREMENTS Clinical data including tumour type and location, surveillance outcomes and interventions, SDHC genetic variant assessment, interpretation, and tumour risk calculation. RESULTS We report 91 SDHC cases, 46 probands and 45 non-probands. Fifty-one cases were disease-affected. Median age at genetic diagnosis was 43 years (range: 11-79). Twenty-four SDHC germline variants were identified including six novel variants. Head and neck paraganglioma (HNPGL, n = 30, 65.2%), extra-adrenal paraganglioma (EAPGL, n = 13, 28.2%) and phaeochromocytomas (PCC) (n = 3, 6.5%) were present. One case had multiple PPGLs. Malignant disease was reported in 19.6% (9/46). Eight cases had non-PPGL SDHC-associated tumours, six gastrointestinal stromal tumours (GIST) and two renal cell cancers (RCC). Cumulative tumour risk (95% CI) at age 60 years was 0.94 (CI: 0.79-0.99) in probands, and 0.16 (CI: 0-0.31) in non-probands, respectively. CONCLUSIONS This study describes the largest cohort of 91 SDHC patients worldwide. We confirm disease-affected SDHC variant cases develop isolated HNPGL disease in nearly 2/3 of patients, EAPGL and PCC in 1/3, with an increased risk of GIST and RCC. One fifth developed malignant disease, requiring comprehensive lifelong tumour screening and surveillance.
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Affiliation(s)
- Sophie T Williams
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
- Department Medical Molecular Genetics, King's College London, Guy's Hospital, London, UK
| | | | - Paul V Carroll
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Barbara M McGowan
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Anand Velusamy
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Gemma White
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Rupert Obholzer
- Department of Ear, Nose, Throat Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Scott Akker
- Department of Endocrinology, St Bartholomew's Hospital, Barts Health NHS Foundation Trust, Cambridge, UK
| | - Nicola Tufton
- Department of Endocrinology, St Bartholomew's Hospital, Barts Health NHS Foundation Trust, Cambridge, UK
| | - Ruth T Casey
- Department of Endocrinology, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
- Department of Medical Genetics, University of Cambridge, Cambridge, UK
| | - Eamonn R Maher
- Department of Medical Genetics, University of Cambridge, Cambridge, UK
| | - Soo-Mi Park
- Department of Clinical Genetics, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - Mary Porteous
- South East Scotland Genetic Service, Western General Hospital, Edinburgh, Scotland, UK
| | - Rebecca Dyer
- South East Scotland Genetic Service, Western General Hospital, Edinburgh, Scotland, UK
| | - Tricia Tan
- Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK
| | - Florian Wernig
- Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK
| | - Angela F Brady
- North West Thames Regional Genetics Service, Northwick Park Hospital, London, UK
| | | | | | - Huw Dorkins
- Department of Clinical Genetics, Leicester Royal Infirmary, Leicester, UK
| | - Fiona Lalloo
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester, UK
| | - Paul Brennan
- Northern Genetics Service, Newcastle Hospitals NHS Foundation Trust, Newcastle, UK
| | - Joseph Carlow
- Northern Genetics Service, Newcastle Hospitals NHS Foundation Trust, Newcastle, UK
| | - Richard Martin
- Northern Genetics Service, Newcastle Hospitals NHS Foundation Trust, Newcastle, UK
| | - Anna L Mitchell
- Department of Endocrinology, Newcastle upon Tyne NHS Hospitals Foundation Trust, Newcastle, UK
| | - Rachel Harrison
- Department of Clinical Genetics, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Lara Hawkes
- Department of Clinical Genetics, Churchill Hospital, Oxford, UK
| | - John Newell-Price
- Department of Oncology and Metabolism, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Alan Kelsall
- Department of Oncology and Metabolism, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Rebecca Igbokwe
- Department of Clinical Genetics, Birmingham Women's Hospital, Birmingham, UK
| | - Julian Adlard
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, UK
| | - Schaida Schirwani
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, UK
| | - Rosemarie Davidson
- Department of Clinical Genetics, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - Patrick J Morrison
- Department of Medical Genetics, Belfast City Hospital, Belfast, Northern Ireland, UK
| | - Teng-Teng Chung
- Department of Endocrinology, University College London Hospital NHS Foundation Trust, London, UK
| | | | - Louise Izatt
- Department Medical Molecular Genetics, King's College London, Guy's Hospital, London, UK
- Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Herlea V, Roșulescu A, Calotă VC, Croitoru V, Stoica Mustafa E, Vasilescu C, Alexandrescu S, Dumitrașcu T, Popescu I, Dima SO, Sajin M. Combined Positive Score for Programmed Death Ligand-1 Expression and Inflammatory Microenvironment in Gastrointestinal Stromal Tumors. Medicina (B Aires) 2022; 58:medicina58020174. [PMID: 35208498 PMCID: PMC8924898 DOI: 10.3390/medicina58020174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: GISTs are the most frequent type of mesenchymal neoplasm of the digestive tract. The prognosis is mainly determined by tumor dimensions, mitotic rate and location, but other less well-documented factors can influence evolution and survival. The immune microenvironment and checkpoint molecule expression were proven to impact the prognosis in different types of cancer. The aim of this study was to determine PD-L1 expression in GISTs and to evaluate the level of intratumoral immune infiltration in relation to prognostic variables and survival. Materials and Methods: Sixty-five GISTs diagnosed in the same institution between 2015 and 2018 were immunohistochemically tested for PD-L1 and evaluated using CPS. Immune cells were emphasized, with CD3, CD4, CD8, CD20 and CD68 antibodies and quantified. All data were processed using statistical tools. Results: The median age was 61 years (range, 28–78) and 36 patients (55.4%) were males. The location of the tumors was predominantly gastric (46%), followed by the small bowel (17%) and colorectal (6%). In addition, 11% were EGISTs and 20% were secondary tumors (11% metastases and 9% local recurrences). PD-L1 had a variable expression in tumor and inflammatory cells, with a CPS ranging from 0 to 100. Moreover, 64.6% of cases were PD-L1 positive with no significant differences among categories of variables, such as the age and the sex of the patient, tumor location, the primary or secondary character of the tumor, dimensions, mitotic rate, the risk of disease progression and tumor cell type. Immune cells had a variable distribution throughout the tumors. CD3+ lymphocytes were the most frequent type. CD20+ cells were identified in a larger number in tumors ≤5 cm (p = 0.038). PD-L1-positive tumors had a higher number of immune cells, particularly CD3+, CD20+ and CD68+, in comparison to PD-L1-negative ones (p = 0.032, p = 0.051, p = 0.008). Epithelioid and mixed cell-type tumors had a higher number of CD68+ cells. Survival was not influenced by PD-L1 expression; instead, it was decreased in multifocal tumors (p = 0.0001) and in cases with Ki67 ≥ 50% (p = 0.008). Conclusions: PD-L1-positive expression and the presence of different immune cell types, in variable quantities, can contribute to a better understanding of the complex interactions between tumor cells and the microenvironment, with a possible therapeutic role in GISTs.
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Affiliation(s)
- Vlad Herlea
- Department of Pathology, Fundeni Clinical Institute, 022328 Bucharest, Romania; (A.R.); (E.S.M.)
- Faculty of Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania;
- Center of Excellence for Translational Medicine, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Correspondence: (V.H.); (S.O.D.)
| | - Alexandra Roșulescu
- Department of Pathology, Fundeni Clinical Institute, 022328 Bucharest, Romania; (A.R.); (E.S.M.)
- “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (S.A.); (T.D.); (M.S.)
| | | | - Vlad Croitoru
- Department of Oncology, Fundeni Clinical Institute, 022328 Bucharest, Romania;
| | - Elena Stoica Mustafa
- Department of Pathology, Fundeni Clinical Institute, 022328 Bucharest, Romania; (A.R.); (E.S.M.)
| | - Cătălin Vasilescu
- “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (S.A.); (T.D.); (M.S.)
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Sorin Alexandrescu
- “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (S.A.); (T.D.); (M.S.)
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Traian Dumitrașcu
- “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (S.A.); (T.D.); (M.S.)
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Irinel Popescu
- Faculty of Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania;
- Center of Excellence for Translational Medicine, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Simona Olimpia Dima
- Center of Excellence for Translational Medicine, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Correspondence: (V.H.); (S.O.D.)
| | - Maria Sajin
- “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (S.A.); (T.D.); (M.S.)
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Yuce E, Alandag C, Cakir E, Fidan E. Prognostic Factors in Gastrointestinal Stromal Tumors (GIST): Could Prognostic Nutritional Index (PNI) be a New Prognostic Factor? J Coll Physicians Surg Pak 2022; 32:81-85. [PMID: 34983153 DOI: 10.29271/jcpsp.2022.01.81] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 09/08/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate factors that may affect prognosis in gastrointestinal stromal tumors (GISTs). STUDY DESIGN A descriptive study. PLACE AND DURATION OF STUDY Karadeniz Technical University Hospital, Trabzon, Turkey from 2000 to 2019. METHODOLOGY All the patients diagnosed with GIST and followed-up in this centre were included. Those who were not followed-up in this centre were excluded. The Chi-square test for differences between variables in independent groups; and the Kaplan-Meier method for survival rates were used. RESULTS Median tumor size was larger in patients with recurrence, compared to those without (8cm vs. 5 cm, p <0.001). Recurrence rates were higher with mitosis ≥5 in 50 high-power-fields than with low mitosis (52.6% vs. 23.4%, p = 0.021). Median Ki-67 percentages were higher in patients with recurrence than without (5 vs. 2, p = 0.031). Recurrence rates were higher with necrosis and bleeding than without (57.7% vs. 14.3%, p = <0.001; 50% vs. 13.8%, p = 0.003). Median overall-survival (OS) was shorter in with mitotic counts ≥5 compared to <5 (52.0 vs. 110.0 months, p = 0.051) and with ulceration than without (36.0 vs. 110.0 months, p = 0.017). The groups below (<43.5) and above (>43.5) the median prognostic-nutritional-index (PNI) value were similar in terms of OS and disease-free survival (DFS) (52 vs. 70 months, p = 0.174; 82 vs. 100 months, p = 0.411). Median DFS was shorter with ulceration than without (27 vs. 100 months, p = 0.048). CONCLUSION While necrosis, bleeding, ulceration, mitosis, size, and Ki-67 significantly affect the prognosis in GIST, PNI has no significant effect. Key Words: Gastrointestinal stromal tumors (GIST), Survival, Prognosis, Recurrence, Prognostic Nutrition Index (PNI).
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Affiliation(s)
- Elif Yuce
- Department of Medical Oncology, Karadeniz Technical University, Trabzon, Turkey
| | | | | | - Evren Fidan
- Department of Medical Oncology, Karadeniz Technical University, Trabzon, Turkey
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Waibl F, Kraml J, Fernández-Quintero ML, Loeffler JR, Liedl KR. Explicit solvation thermodynamics in ionic solution: extending grid inhomogeneous solvation theory to solvation free energy of salt-water mixtures. J Comput Aided Mol Des 2022; 36:101-116. [PMID: 35031880 PMCID: PMC8907097 DOI: 10.1007/s10822-021-00429-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/28/2021] [Indexed: 12/03/2022]
Abstract
Hydration thermodynamics play a fundamental role in fields ranging from the pharmaceutical industry to environmental research. Numerous methods exist to predict solvation thermodynamics of compounds ranging from small molecules to large biomolecules. Arguably the most precise methods are those based on molecular dynamics (MD) simulations in explicit solvent. One theory that has seen increased use is inhomogeneous solvation theory (IST). However, while many applications require accurate description of salt-water mixtures, no implementation of IST is currently able to estimate solvation properties involving more than one solvent species. Here, we present an extension to grid inhomogeneous solvation theory (GIST) that can take salt contributions into account. At the example of carbazole in 1 M NaCl solution, we compute the solvation energy as well as first and second order entropies. While the effect of the first order ion entropy is small, both the water-water and water-ion entropies contribute strongly. We show that the water-ion entropies are efficiently approximated using the Kirkwood superposition approximation. However, this approach cannot be applied to the water-water entropy. Furthermore, we test the quantitative validity of our method by computing salting-out coefficients and comparing them to experimental data. We find a good correlation to experimental salting-out constants, while the absolute values are overpredicted due to the approximate second order entropy. Since ions are frequently used in MD, either to neutralize the system or as a part of the investigated process, our method greatly extends the applicability of GIST. The use-cases range from biopharmaceuticals, where many assays require high salt concentrations, to environmental research, where solubility in sea water is important to model the fate of organic substances.
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Affiliation(s)
- Franz Waibl
- Department of General, Inorganic, and Theoretical Chemistry, University of Innsbruck, Innrain 80/82, 6020, Innsbruck, Austria
| | - Johannes Kraml
- Department of General, Inorganic, and Theoretical Chemistry, University of Innsbruck, Innrain 80/82, 6020, Innsbruck, Austria
| | - Monica L Fernández-Quintero
- Department of General, Inorganic, and Theoretical Chemistry, University of Innsbruck, Innrain 80/82, 6020, Innsbruck, Austria
| | - Johannes R Loeffler
- Department of General, Inorganic, and Theoretical Chemistry, University of Innsbruck, Innrain 80/82, 6020, Innsbruck, Austria
| | - Klaus R Liedl
- Department of General, Inorganic, and Theoretical Chemistry, University of Innsbruck, Innrain 80/82, 6020, Innsbruck, Austria.
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Lo YY, Malicki D, Levy M, Crawford JR. Unusual low-grade neuroepithelial tumour with novel PDGFRA mutation. BMJ Case Rep 2021; 14:e247411. [PMID: 34764135 PMCID: PMC8587696 DOI: 10.1136/bcr-2021-247411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Yan Yuen Lo
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Denise Malicki
- Department of Pathology, Rady Children's Hospital University of California San Diego, San Diego, California, USA
| | - Michael Levy
- Department of Neurosurgery, University of California San Diego, San Diego, California, USA
| | - John Ross Crawford
- Departments of Neurosciences and Pediatrics, University of California San Diego, La Jolla, California, USA
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Abstract
PURPOSE To examine the computed tomography (CT) images of patients with a diagnosis of gastric tumor by texture analysis and to investigate its place in differential diagnosis. MATERIALS AND METHODS Contrast enhanced venous phase CT images of 163 patients with pathological diagnosis of gastric adenocarcinoma (n = 125), gastric lymphoma (n = 12) and gastrointestinal stromal tumors (n = 26) were retrospectively analyzed. Pixel size adjustment, gray-level discretization and gray-level normalization procedures were applied as pre-processing steps. Region of interest (ROI) was determined from the axial slice that represented the largest lesion area and a total of 40 texture features were calculated for each patient. Texture features were compared between the tumor subtypes and between adenocarcinoma grades. Statistically significant texture features were combined into a single parameter by logistic regression analysis. The sensitivity and specificity of these features and the combined parameter were measured to differentiate tumor subtypes by receiver-operating characteristic curve (ROC) analysis. RESULTS Classifications between adenocarcinoma versus lymphoma, adenocarcinoma vs. gastrointestinal stromal tumor (GIST) and well-differentiated adenocarcinoma versus poorly differentiated adenocarcinoma using texture features yielded successful results with high sensitivity (98, 91, 96%, respectively) and specificity (75, 77, 80%, respectively). CONCLUSIONS CT texture analysis is a non-invasive promising method for classifying gastric tumors and predicting gastric adenocarcinoma differentiation.
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Affiliation(s)
- Tolga Zeydanli
- Radiology Department, Ardahan Devlet Hastanesi, 75000, Ardahan, Turkey.
| | - Huseyin Koray Kilic
- Radiology Department, Gazi University School of Medicine, 06500, Ankara, Turkey
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Lu ZY, Zhao DY. Gastric schwannoma treated by endoscopic full-thickness resection and endoscopic purse-string suture: A case report. World J Gastroenterol 2021; 27:3940-3947. [PMID: 34321856 PMCID: PMC8291012 DOI: 10.3748/wjg.v27.i25.3940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/02/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Schwannomas, also known as neurinomas, are tumors that derive from Schwann cells. Gastrointestinal schwannomas are extremely rare, but the stomach is the most common site. Gastric schwannomas are usually asymptomatic. Endoscopy and imaging modalities might offer useful preliminary diagnostic information. However, to diagnose schwannoma, the immunohistochemical positivity for S-100 protein is essential, whereas CD117, CD34, SMA, desmin, and DOG-1 are negative.
CASE SUMMARY A 45-year-old female was found to have a gastric mass during a medical examination, which was diagnosed as a gastric schwannoma. We performed endoscopic full-thickness resection and endoscopic purse-string suture. Pathology and immunohistochemical staining confirmed the diagnosis of gastric schwannoma through the positivity of S-100 protein. Furthermore, to exclude the misdiagnosis of gastrointestinal stromal tumor, we performed a mutational detection of the c-Kit and PDGFRA genes. Postoperative follow-up revealed that the patient recovered well.
CONCLUSION Immunohistochemical staining is essential for the diagnosis of schwannoma. Endoscopic full-thickness resection is an effective treatment method for gastric schwannoma.
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Affiliation(s)
- Zhi-Yu Lu
- Departments of Gastroenterology, Institute of Digestive, Southwest Hospital, Army Military Medical University, Chongqing 400038, China
| | - Dun-Yong Zhao
- Departments of Gastroenterology, Institute of Digestive, Southwest Hospital, Army Military Medical University, Chongqing 400038, China
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Epstein AS, Kakarala SE, Reyna VF, Saxena A, Maciejewski PK, Shah MA, Prigerson HG. Development of the Oncolo-GIST ("Giving Information Strategically & Transparently") Intervention Manual for Oncologist Skills Training in Advanced Cancer Prognostic Information Communication. J Pain Symptom Manage 2021; 62:10-19.e4. [PMID: 33253786 PMCID: PMC8155099 DOI: 10.1016/j.jpainsymman.2020.11.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 01/01/2023]
Abstract
CONTEXT Patient prognostic understanding is improved by oncologists' discussions of life expectancy. Most patients deem it important to discuss prognosis with their oncologists, but a minority of cancer patients within months of death report that they had such a discussion with their oncologist. OBJECTIVES To query stakeholders about their perspectives on the clinical approach and utility of an Oncolo-GIST manualized communication intervention, designed to enhance oncologists' ability to convey the gist of prognostic information simply, clearly, and effectively in the setting of progressing solid tumors and limited life expectancy. METHODS We obtained and analyzed feedback on the intervention from solid tumor oncology clinicians and bereaved family caregivers, soliciting opinions on the clinical approach taken in the videos, acceptability and likely impact of the instructions, and specific phrases recommended in the manual. RESULTS Twenty stakeholders (9 clinicians, 11 caregivers) participated. All agreed that oncologists should broach prognosis with patients, balancing honesty and sensitivity. Participants also advocated for oncologists to involve interprofessional team members (e.g., nurses, social workers) when serious mental health concerns arose. After the research team's discussion of the stakeholder feedback, the manual was modified to include or exclude preferred language and approaches. CONCLUSION The Oncolo-GIST intervention was characterized as simple and potentially effective at conveying prognoses to advanced cancer patients. Future research should determine if this approach to medical communication, which distills the essence of prognostic messages clearly and simply, is associated with improvements in patients' prognostic understanding.
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Affiliation(s)
- Andrew S Epstein
- Memorial Sloan Kettering Cancer Center, New York, New York, USA; Weill Cornell Medicine, New York, New York, USA.
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Yan F, Yu X, Lei H, Chen Y, Wang J, Li J. A rare case of gastric fundus tuberculosis with nonspecific abdominal pain. J Int Med Res 2021; 49:3000605211033189. [PMID: 34311596 PMCID: PMC8320578 DOI: 10.1177/03000605211033189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/28/2021] [Indexed: 11/17/2022] Open
Abstract
A 53-year-old patient who experienced recurring upper abdominal pain and discomfort for 4 years was admitted to our hospital. Gastroscopy was performed to identify the location of the pain and evaluate the characteristics of a mass in the abdomen. Endoscopic ultrasonography (EUS) and abdominal computed tomography (CT) revealed a space-occupying lesion in the gastric fundus, suggestive of a submucosal tumor and highly likely of stromal origin. Surgical resection of the lesion was performed for identification; however, postoperative histopathological examination of the lesion revealed gastric fundus tuberculosis (TB). Gastric TB is relatively rare; therefore, clinicians should be highly suspicious of patients with abdominal symptoms from regions with a high incidence of TB to prevent treatment delay caused by misdiagnosis.
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Affiliation(s)
- Feiyu Yan
- Department of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical College, Affiliated Hospital of Zunyi Medical College, Zunyi, People’s Republic of China
| | - Xianzhe Yu
- Department of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical College, Affiliated Hospital of Zunyi Medical College, Zunyi, People’s Republic of China
| | - Hongjun Lei
- Department of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical College, Affiliated Hospital of Zunyi Medical College, Zunyi, People’s Republic of China
| | - Yi Chen
- Department of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical College, Affiliated Hospital of Zunyi Medical College, Zunyi, People’s Republic of China
| | - Jiwei Wang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical College, Affiliated Hospital of Zunyi Medical College, Zunyi, People’s Republic of China
| | - Jianguo Li
- Department of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical College, Affiliated Hospital of Zunyi Medical College, Zunyi, People’s Republic of China
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Shannon AB, Song Y, Fraker DL, Roses RE, DeMatteo RP, Miura JT, Karakousis GC. Surgical resection of gastric gastrointestinal stromal tumors (GIST) in octogenarians. Am J Surg 2021; 223:325-330. [PMID: 33867048 DOI: 10.1016/j.amjsurg.2021.03.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/25/2021] [Accepted: 03/28/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Localized gastrointestinal stromal tumors (GISTs) are rare tumors typically managed with surgery, but outcomes among octogenarians remain less studied. METHODS Octogenarian patients with stage I-III gastric GISTs were identified from the National Cancer Database and classified by resection status. Cox regression and Kaplan-Meier survival analyses analyzed 5-year overall survival (OS). Ninety-day mortality was analyzed following 1:1 propensity score matching. RESULTS Identified octogenarians (N = 949) who underwent resection (N = 632) had improved adjusted OS (71% vs 59.6%, HR 0.75, p 0.049) as compared to non-resected patients. Following matching, 90-day mortality was 5.7% and 11% in resected and non-resected patients (p 0.052), respectively. After exclusion of patients with 90-day mortality, resected patients maintained an OS advantage (77.3% vs 71.1%, HR 0.64, p 0.028). CONCLUSIONS The majority of octogenarians with localized gastric GIST are treated with surgery portending improved survival but an appreciable mortality, suggesting a necessity for careful selection of older patients for surgery.
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Affiliation(s)
- Adrienne B Shannon
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA, 19146, USA.
| | - Yun Song
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA, 19146, USA
| | - Douglas L Fraker
- Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA, 19146, USA
| | - Robert E Roses
- Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA, 19146, USA
| | - Ronald P DeMatteo
- Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA, 19146, USA
| | - John T Miura
- Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA, 19146, USA
| | - Giorgos C Karakousis
- Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA, 19146, USA
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Zhang Q, Zhao JY, Zhuang H, Lu CY, Yao J, Luo Y, Yu YY. Transperineal core-needle biopsy of a rectal subepithelial lesion guided by endorectal ultrasound after contrast-enhanced ultrasound: A case report. World J Gastroenterol 2021; 27:1354-1361. [PMID: 33833488 PMCID: PMC8015297 DOI: 10.3748/wjg.v27.i13.1354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/29/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Rectal subepithelial lesions (SELs) are commonly seen in endoscopic examination, generally manifested as bumps with a smooth surface. Precise preoperative diagnoses for rectal SELs are difficult because abnormal tissues are not easily to be obtained by regular endoscopic forceps biopsy. Traditional guidance modalities of preoperative biopsy, including endoscopic ultrasound, computed tomography, and transabdominal ultrasound, are often unsatisfactory. An updated, safe, and effective biopsy guidance method is required. We herein report a new biopsy guidance modality—endorectal ultrasound (ERUS) combined with contrast-enhanced ultrasound (CEUS).
CASE SUMMARY A 32-year-old woman complained of a mass inside the rectovaginal space for 9 years, which became enlarged within 1 year. A rectal SEL detected by endoscopy was suspected to be a gastrointestinal stromal tumor or exophytic uterine fibroid. Pathological diagnosis was difficult because of unsuccessful transabdominal core needle biopsy with insufficient tissues, as well as vaginal hemorrhage. A second biopsy was suggested after multiple disciplinary treatment discussion, which referred to a transperineal core needle biopsy (CNB) guided by ERUS combined with CEUS. Adequate samples were procured and rectal gastrointestinal stromal tumor was proved to be the pathological diagnosis. Imatinib was recommended for first-line therapy by multiple disciplinary treatment discussion. After the tumor shrunk, resection of the rectal gastrointestinal stromal tumor was performed through the posterior vaginal wall. Adjuvant therapy was applied and no recurrence or metastasis has been found by the last follow-up on December 13, 2019.
CONCLUSION Transperineal CNB guided by ERUS and CEUS is a safe and effective preoperative biopsy of rectal SELs yet with some limitations.
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Affiliation(s)
- Qiong Zhang
- Department of Diagnostic Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jie-Ying Zhao
- Department of Diagnostic Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Hua Zhuang
- Department of Diagnostic Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chun-Yan Lu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jin Yao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yuan Luo
- Department of Diagnostic Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yong-Yang Yu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Park JY, Lee ES, Hwang HW, Park HJ, Kim BJ, Choi CH. Heterotopic pancreas: the added value of endoscopic ultrasound with Computed Tomography for diagnosis. Med Ultrason 2021; 23:22-28. [PMID: 33220032 DOI: 10.11152/mu-2704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIMS To investigate the added value of endoscopic ultrasound (EUS) with computed tomography (CT) in distinguishing heterotopic pancreas (HP) from other pathologies, when gastroduodenal subepithelial tumors (SETs) are suspected on an upper endoscopic examination. MATERIAL AND METHODS We retrospectively included 54 consecutive patients with gastroduodenal SETs who had undergone both abdominal CT and EUS within a 3-month interval. All EUS, endoscopy, and CT images were reviewed and evaluated in a blinded manner by an endoscopist and a radiologist, respectively. Univariate and multivariate analyses were performed to identify EUS/CT findings related to HP. Diagnostic performance of CT only and CT combined with EUS was compared for distinguishing HP from other SETs. RESULTS We included patients with HP (n=17; pathologically confirmed, n=6), gastrointestinal stromal tumor (GIST, n=24), and other pathologies (n=13). Multivariate logistic regression analyses revealed that irregular margin, origin from submucosal layer, internal microcystic-tubular structure, and oval shape were independent factors in diagnosing HP by EUS, whereas a micro-lobulating contour was the only significantly independent factor in CT. In assessments of diagnostic performance, CT combined with EUS showed significantly superior diagnostic performance in comparison with CT only (area under the curve, 0.961 vs. 0.833, p=0.028) in the consensus interpretation of an endoscopist and a radiologist. CONCLUSIONS CT combined with EUS with a comprehensive and complementary interpretation showed significant added value compared to CT only in diagnosing gastroduodenal HP.
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Affiliation(s)
- Jae Yong Park
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea.
| | - Eun Sun Lee
- Department of Radiology, Chung-Ang University Hospital, Seoul, South Korea; The institute of Evidence based clinical medicine, Chung-Ang University, Seoul, South Korea.
| | - Hye Won Hwang
- Department of Pathology, Chung-Ang University Hospital, Seoul, South Korea.
| | - Hyung Jeong Park
- Department of Radiology, Chung-Ang University Hospital, Seoul, South Korea.
| | - Beom Jin Kim
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea; The institute of Evidence based clinical medicine, Chung-Ang University, Seoul, South Korea.
| | - Chang Hwan Choi
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea.
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Sauri FM, Zakarneh EA, Alessa MY, Sakr AH, Chung YS, Kim HS, Kim NK. Triple synchronous primary neoplasms in the gastrointestinal tract. Chin Med J (Engl) 2021; 134:1233-1235. [PMID: 33538507 PMCID: PMC8143777 DOI: 10.1097/cm9.0000000000001389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- Fozan Mohammed Sauri
- Department of Surgery, Colorectal Division, Yonsei University College of Medicine, Seoul, 120-752, South Korea
| | - Eman Adnan Zakarneh
- Department of Surgery, Colorectal Division, Yonsei University College of Medicine, Seoul, 120-752, South Korea
| | - Mohammed Yousef Alessa
- Department of Surgery, Colorectal Division, Yonsei University College of Medicine, Seoul, 120-752, South Korea
- Department of General Surgery, King Faisal University, Alahsa 31982, Saudi Arabia
| | - Ahmad Hammad Sakr
- Department of Surgery, Colorectal Division, Yonsei University College of Medicine, Seoul, 120-752, South Korea
- Colorectal Surgery Unit, Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University Hospital, Mansoura 35511, Egypt
| | - Yeon Seung Chung
- Department of Pathology, Yonsei University College of Medicine, Seoul 120-752, South Korea
| | - Ho Seung Kim
- Department of Surgery, Colorectal Division, Yonsei University College of Medicine, Seoul, 120-752, South Korea
| | - Nam Kyu Kim
- Department of Surgery, Colorectal Division, Yonsei University College of Medicine, Seoul, 120-752, South Korea
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44
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Saffon A MA, Roldan M LF, Caro Y, Restrepo T CE, Barraza A M, Restrepo HD. [Cyst of gastric duplication in adults. Case report and review of the bibliography]. Rev Gastroenterol Peru 2020; 40:342-345. [PMID: 34087924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Gastrointestinal tract duplications are rare congenital malformations that can affect any segment of the digestive tract. They usually occur in the first two years of life with symptoms of poor weight gain and palpable abdominal mass or may be asymptomatic until adulthood. We report the case of a 37-year-old male patient who was evaluated for epigastralgia and a history of upper gastrointestinal bleeding. High endoscopy revealed ulcerated subepithelial lesion in gastric fundus with diagnostic suspicion of gastrointestinal stromal tumor (GIST). Endoscopic ultrasound confirmed gastric mass with foci of necrosis and calcification, compatible with stromal tumor type GIST. Distal gastric resection was performed in wedge without complications. The pathology report noted gastric duplication.
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Li HL, Wang LH, Hu YL, Feng Y, Li XH, Liu YF, Li P, Mao QS, Xue WJ. Clinical and prognostic significance of CC chemokine receptor type 8 protein expression in gastrointestinal stromal tumors. World J Gastroenterol 2020; 26:4656-4668. [PMID: 32884223 PMCID: PMC7445867 DOI: 10.3748/wjg.v26.i31.4656] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/07/2020] [Accepted: 07/18/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. Surgical resection and tyrosine kinase inhibitors are defined as the main treatments but cannot cure patients with advanced GIST, which eventually develops into recurrence and acquired drug resistance. Therefore, it is necessary to identify prognostic biomarkers and new therapeutic targets for GISTs. CC chemokine receptor type 8 (CCR8) protein participates in regulation of immune responses. Recent studies on CCR8 in non-small cell lung cancer and colorectal cancer showed that it was highly expressed in tumor-infiltrating regulatory T cells and correlated with a poor prognosis.
AIM To detect CCR8 expression in GIST tissues and analyze its relationships with clinicopathological features and prognosis in patients with GISTs.
METHODS Tissue samples were used for the tissue microarrays construction. The microarrays were then subjected to immunohistochemical analyses to detect CCR8 expression. Next, Kaplan–Meier analysis was utilized to calculate the survival rate of patients with complete follow-up data, and the potential prognostic value of CCR8 was evaluated by Cox regression analysis. Finally, a Gene Ontology/Kyoto Encyclopedia of Genes and Genomes single-gene enrichment chart of CCR8 was constructed using the STRING database.
RESULTS CCR8-positive signals were detected as brown or brown-yellow particles by immunohistochemistry located in the cytoplasm. Among 125 tissue samples, 74 had CCR8 high expression and 51 had low or negative expression. Statistical analyses suggested CCR8 was significantly correlated with tumor size, mitotic index, AFIP-Miettinen risk classification and tumor location. Kaplan–Meier and multivariate analyses showed that patients with low or negative CCR8 expression, mitotic index < 5/high-power fields (HPF) and tumor diameter < 5 cm had a better prognosis. Based on the STRING database, CCR8 was significantly enriched in biological processes such as tumor immunity, T lymphocyte chemotaxis, migration and pathways like the nuclear factor-κB and tumor necrosis factor pathways as well as intestinal immune regulation networks.
CONCLUSION CCR8 is a prognostic biomarker for malignant potential of GISTs, with high expression correlated with malignancy and poor prognosis.
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Affiliation(s)
- Huai-Liang Li
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong 226001, Jiangsu Province, China
| | - Lin-Hua Wang
- Department of Intensive Care Unit, Nantong University Affiliated Hospital, Nantong 226001, Jiangsu Province, China
| | - Yi-Lin Hu
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong 226001, Jiangsu Province, China
| | - Ying Feng
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong 226001, Jiangsu Province, China
| | - Xiao-Hong Li
- Department of Surgical Comprehensive Laboratory, Nantong University Affiliated Hospital, Nantong 226001, Jiangsu Province, China
| | - Yi-Fei Liu
- Department of Pathology, Nantong University Affiliated Hospital, Nantong 226001, Jiangsu Province, China
| | - Peng Li
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong 226001, Jiangsu Province, China
| | - Qin-Sheng Mao
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong 226001, Jiangsu Province, China
| | - Wan-Jiang Xue
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong 226001, Jiangsu Province, China
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Endo S, Kojiro M, Yoshioka H, Nishizu R, Hor B, Phean P, Yamamoto I, Takeda M, Yoshioka H. [A Case of Giant Gastrointestinal Stromal Tumor of the Jejunum in the Kingdom of Cambodia]. Gan To Kagaku Ryoho 2020; 47:1121-1123. [PMID: 32668866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 60-year-old Khmer woman visited a hospital established by a Japanese non-profit organization in the Kingdom of Cambodia with complaints of swelling in the left abdomen and appetite loss for 2 months. Abdominal computed tomography scan showed a mass measuring 14.6×13.4×19.3 cm with internal necrosis in the left abdomen. On laparotomy, a large tumor involving the jejunum had adhered to the transverse and descending colons. The tumor, measuring 25×20×10 cm and weighing 2,994 g, was excised along with 65 cm of the jejunum. Histopathological examination revealed a gastrointestinal stromal tumor(GIST). Postoperative course was uneventful. Thanks to the cooperation with the Japanese and the Cambodian people, the surgery was successful in spite of a shortage of medical personnel and medical resources in Cambodia.
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Nguyen V, Banerjee S, Sicklick JK. Moving gastrointestinal stromal tumours towards truly personalised precision therapy. Lancet Oncol 2020; 21:865-867. [PMID: 32615099 DOI: 10.1016/s1470-2045(20)30335-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Vi Nguyen
- Division of Surgical Oncology, Department of Surgery, University of California, San Diego, CA 92093-0987, USA
| | - Sudeep Banerjee
- Department of Surgery, University of California, Los Angeles, CA, USA
| | - Jason K Sicklick
- Division of Surgical Oncology, Department of Surgery, University of California, San Diego, CA 92093-0987, USA.
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48
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Uraoka M, Okada T, Fujimoto Y, Yamamura M, Ueno T. [Case of Intestinal GIST with Long-Term Survival after Multidisciplinary Treatment, Including Surgical Resection for Liver Metastasis]. Gan To Kagaku Ryoho 2020; 47:147-149. [PMID: 32381887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 54-year-old male underwent partial resection of the ileum for gastrointestinal stromal tumor(GIST). Although it was a high-risk GIST, he was followed-up without chemotherapy. Nineteen months after the initial operation, an EOB-MRI showed a mass in the liver(S8). As it had increased in size in 4 months of follow-up, 400mg/day of imatinib was started for the diagnosis of liver metastasis. The patient experienced PR 6 months after the initiation of chemotherapy and underwent partial hepatectomy. Imatinib 400mg/day was re-administered after hepatectomy, and the disease was well controlled for 16 months. Imatinib is acceptable as the first-line therapy for unresectable and metastatic GIST. The significance of surgical intervention remains unclear for liver metastasis in GIST; however, it could remain uncontrolled with surgery alone and requires concomitant imatinib therapy. On the other hand, imatinib could be beneficial and its life-long continuation is critical, but most patients eventually develop drug resistance. Complete resection of the metastatic site along with chemotherapy could lead to reduction of secondary resistance to imatinib and prolong the survival rate.
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Affiliation(s)
- Mio Uraoka
- Dept. of General Surgery, Matsuyama Shimin Hospital
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Taguchi T, Nagase H, Noguchi K, Hirota M, Oshima K, Tanida T, Noura S, Kawase T, Imamura H, Iwazawa T, Akagi K, Andou H, Tamura Y, Adachi S, Douno K. [Gastric Gastrointestinal Stromal Tumor Appearing Nine Years after Resection of a Duodenal Gastrointestinal Stromal Tumor-A Case Report]. Gan To Kagaku Ryoho 2020; 47:144-146. [PMID: 32381886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Multiple sporadic gastrointestinal stromal tumor(GIST)are rare, except for those restricted to von Recklinghausen disease or hereditary conditions.We reported a case of a gastric GIST resected 9 years after the resection of a duodenal GIST.The patient was a 58-year-old male who had been followed-up with computed tomography scans after pancreatoduodenectomy for a duodenal GIST when he was 49-years-old.The patient was admitted to our hospital for anemia examination.A CT scan detected a tumor in the stomach, with a diameter of over 10 cm, and necrosis.Esophagogastroduodenoscopy revealed the presence of a delle on the gastric SMT.Due to suspected invasion of the spleen and left diaphragm by the tumor, we performed subtotal gastrectomy with splenectomy and left diaphragm segmental resection.In the pathological diagnosis, the tumor was diagnosed as a gastric GIST, because the cell type of the tumor was spindle and tested positive for c-kit.Based on the tumor size and mitotic count, the patient was diagnosed with high-risk GIST by the modified-Fletcher classification, and imatinib 400mg/day was administered.There have been no signs of recurrence for 2 years since the operation.
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Uno H, Takahara Y, Nishida T, Ohno T, Komatsu T. [A Case of Laparoscopic Local Resection of the Stomach for an Inflammatory Myofibroblastic Tumor]. Gan To Kagaku Ryoho 2019; 46:2054-2056. [PMID: 32157057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 52-year-old man underwent upper gastrointestinal endoscopy screening that identified a submucosal tumor in the gastric fornix, and a solid tumor with a maximum diameter of 35mm was suspected based on abdominal computed tomography. An endoscopic ultrasound-guided fine needle aspiration biopsy showed spindle-shaped cells with KIT, CD34, desmin, and S-100 all testing negative. Based on the diagnosis of a gastrointestinal stromal tumor, subtotal gastrectomy was performed laparoscopically. Postsurgical histopathological testing led to a diagnosis of a primary gastric inflammatory myofibroblastic tumor. The present case has been defined as one involving a tumor part way along the spectrum between benign and malignant, with local recurrence and distal metastasis. Reports indicate that recurrence occurs frequently in cases wherein sufficient margins are not obtained or wherein there is enucleation, and complete surgical resection is recommended. With laparoscopic surgery, because an enlarged field of view can be obtained, and depending on the lesion site, good exposure of the operative field is possible, the authors believe that this approach would be beneficial in terms of local control. Moreover, it has been reported that anaplastic lymphoma kinase(ALK), which is a tyrosine kinase receptor protein, tests positive in approximately 60% of cases. Reports have also indicated that distal metastasis occurs frequently in cases in which ALK tests negative, and watchful waiting of these cases at regular intervals should be carried out to the same extent as of cases involving malignant tumors.
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