• Title/Summary/Keyword: gastrointestinal stromal tumor

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2005~2006 Nationwide Gastric Submucosal Tumor Report in Korea (2005~2006년 전국 위점막하종양 설문조사 결과 보고)

  • The Information Committee of the Korean Gastric Cancer Association,
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.104-109
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    • 2008
  • Purpose: To investigate the clinicopathlogical characteristics and the surgical methods for gastric submucosal tumors in Korea, the Information Committee of the Korean Gastric Cancer Association performed a nationwide survey. Materials and Methods: Data on 878 patients who underwent resection from 2005 to 2006 were collected from medical records obtained from 47 institutes. Diagnosis, demographics, symptoms, tumor factors (location, size, degree of malignancy) and operative factors (surgicalmethod and approach, mortality) were analyzed. Results: Gastrointestinal stromal tumors (GISTs) were the most common cancers (n=586, 66.8%), followed by leiomyomas (n=97, 11.1%), schwannomas (n=70, 8.0%), ectopic pancreas (n=67, 7.8%) and carcinoids (n=16, 1.8%). The mean age of patients was 56.0 years and the male to female ratio was 1:1.18. Only 40.9% of the patients had symptoms at the time of diagnosis, such as abdominal pain, dyspepsia and bleeding. Gastric submucosal tumors were most frequently located in the upper third of the stomach and 55.4% of the GISTs (n=319) and 84.5% of the leiomyomas (n=84.5%) were located in the upper third of the stomach. Wedge resection (n=726, 82.8%) was the most common operative method, and laparoscopic surgery was performed in 388 patients (44.2%). Only one patient (0.1%) died within 30 days of surgery. A total of 115 patients withGISTs (21.1%, 115/544) had a high risk of malignancy and 41 patients (8.3%, 45/495) received adjuvant imatinib mesylate therapy. Conclusion: The survey showed that about two-thirds of the patients with a gastric submuscoal tumor (SMT) had a GIST, and about one-half of the patients underwent laparoscopic resection. These data presented in the nationwide survey could be used as a fundamental resource for gastric submucosal tumors in Korea.

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Gastrointestinal Stromal tumor of the Esophagus (식도에 발생한 위장관 간질종양)

  • Park Young-Woo;Shin Hwa-Kyun;Lim Jae-Ung;Koh Eun-Suk;Kim Hee-Kyung;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.565-568
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    • 2006
  • A 46-year-old man who had been diagnosed with esophageal tumor by PET-CT was admitted to our hospital for operation. Preoperative examination and intraoperative findings showed leiomyoma-like lesion and enucleation was done, but an immunohistochemical test on the case found gastrointestinal stromal tumor (GISTs). GISTs are very rarely found in the esophagus. As GISTs differ from leiomyoma pathogenetically and clinically, different treatments and follow-up strategies are required. The patient is under continuous observation to check recurrence and metastasis.

Excision of Malignant Gastrointestinal Stromal Tumor of Distal Esophagus and Stomach using Thoracoabdominal Incision (흉복부 절개를 이용한 식도와 위에 발생한 거대 악성 위장관 간질 종양의 절제)

  • Hwang Jin Wook;Son Ho Sung;Jo Jong Ho;Park Sung Min;Lee Song Am;Sun Kyung;Kim Kwang Taik
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.514-517
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    • 2005
  • Gastrointestinal stromal tumor is documented on every part of the gastrointestinal tract. It develops in the stomach and the small intestine most commonly, and also in the esophagus. A 44 year-old male patient was admitted due to dysphagia and weight loss. Chest CT showed about $15\times11\times11cm$ sized, well-defined, and lobulated soft tissue mass with central necrosis was noted in the posterior wall of lower esophagus throughout the lesser curvature of upper stomach. We performed the distal esophagectomy and total gastrectomy using thoracoabdominal incision. The tumor was positive at CD117 (c-kit) and CD 34, and was diagnosed as malignant GIST of the distal esophagus and upper stomach. The patient is on routine follow up at the out patient department for nineteen months up to now.

Malignant Gastrointestinal Stromal Tumor of Esophagus - A case report - (식도의 악성 위장관 간질종양 - 1례 보고 -)

  • Kang, Shin-Kwang;Won, Tae-Hee;Ku, Kwan-Woo;Yoon, Soo-Young;Yu, Jae-Hyun;Na, Myung-Hoon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.36 no.2
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    • pp.109-112
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    • 2003
  • Stromal tumors of the gastrointestinal tract, especially of the esophagus, are rare. We had a case of malignant gastrointestinal stromal tumor(GIST) of the esophagus. A 46 years old woman was admitted for abnormal mass shadow in the chest radiograph. The mass was originated from the lower thoracic esophagus, and compressed the right lower pulmonary vein and the inferior vena cava. We removed the tumor externally without injuring of the esophageal mucosa via right posterolateral thoracotomy. The tumor was positive for CD 34 and CD 117, and diagnosed malignant CIST of the esophagus.

Mutational Analysis of the Epidermal Growth Factor Receptor Gene in Gastrointestinal Stromal Tumors (위장관 간질성 종양의 Epidermal Growth Factor Receptor 유전자 돌연변이 연구)

  • Yoo Nam Jin;Lee Jong Woo;Soung Young Hwa;Jeon Hae Myung;Nam Suk Woo;Kim Su Young;Park Won Sang;Lee Jung Young;Lee Sug Hyung
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.268-271
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    • 2004
  • Purpose: Most gastrointestinal stromal tumors (GISTs) have gain-of-function mutations of the KIT or the platelet-derived growth factor receptor alpha (PDGFRA) genes, but approximately $10\%$ of the GISTs are wild types for both the KIT and the PDGFRA genes. The purpose of this study was to investigate the possibility that epidermal growth factor receptor (EGFR) gene mutation might be responsible for the pathogenesis of GIST. Materials and Methods: We analyzed the EGFR gene in 60 GISTs for the detection of somatic mutations by using the polymerase chain reaction (PCR), the single strand conformation polymorphism (SSCP), and DNA sequencing in exon 18, 19, and 21 encoding the kinase domain. Results: The SSCP analysis revealed no evidence of EGFR mutations in exon 18, 19, and 21 in GISTs. Conclusion: The data indicate that the EGFR gene may not be mutated in human GIST and suggest that therapies targeting the mutated EGFR gene products might not be useful in the treatment of GISTs.

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Comparisons of C-kit, DOG1, CD34, PKC-θ and PDGFR-α Expressions in Gastrointestinal Stromal Tumors According to Histopathological Risk Classification

  • Kim, Ki-Sung;Song, Hye-Jung;Shin, Won-Sub;Song, Kang-Won
    • Korean Journal of Clinical Laboratory Science
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    • v.43 no.2
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    • pp.48-56
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    • 2011
  • Gastrointestinal stromal tumor (GIST) is a mesenchymal tumor and is associated with a specific immunophenotype index. It is very important to identify the specific immunophenotype and the diagnosis for the treatment GIST patients. Ninety two cases of GIST analyzed in this study were immuno-stained for c-kit, DOG1, CD34, PKC-${\theta}$, PDGFR-${\alpha}$. The rate of positive staining and statistical significance were then compared. In addition, the GISTs were analyzed as followings: very low risk, low risk, intermediate risk and high risk according to tumor size and nuclear division, and later correlated with clinical parameters. The results of the GIST positive stainings were: DOG1 (95.7%), PKC-${\theta}$ (90.2%), PDGFR-${\alpha}$ (88.0%), c-kit (87.0%) and CD34 (71.7%). Only DOG1 staining showed a statistical significance of p<0.05. It was identified in the classification system of histologic risk that staining expression of DOG1, PKC-${\theta}$, PDGFR-${\alpha}$ were significantly increased as histologic risk increases (p<0.05). However, clinical parameters such as age and sex of patients have no correlations with the classification system of histologic risk (p>0.05). Therefore, in this study, the expression of DOG1 showed statistical significance and DOG1, PKC-${\theta}$, PDGFR-${\alpha}$ staining increased significantly as the histologic risk increases in histologic classification system. Taken together, the DOG1 staining should be very effective for the diagnosis of GIST patients.

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A Case of Imatinib-mesylate associated Hypersensitivity Pneumonitis (Imatinib-mesylate에 의한 과민성 폐렴 1예)

  • Lee, Jae Wong;Kim, Hye Jin;Kim, Kyu Jin;Shin, Kyeong Cheol;Hong, Yeong Hoon;Chung, Jin Hong;Lee, Kwan Ho
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.423-426
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    • 2005
  • Imatinib-mesylate (Gleevec, Glivec) is a protein-tyrosine kinase inhibitor that inhibits the Bcr-Abl tyrosine kinase created by the Philadelphia chromosome abnormality in CML. Imatinib is also used to treat patients with c-kit (CD 117)-positive unresectable tumors, or metastatic malignant gastrointestinal stromal tumors, or both. Imatinib is a welltolerated drug with few side effects. However, it has been associated with gastrointestinal irritation, fluid retention and edema, skin rashes, depigmentation, hepatotoxicity, hemorrhage, and hematological toxicity (anemia, neutropenia, and thrombocytopenia). In addition, imatinib has been associated with dyspnea and cough, which are mainly secondary to the pleural effusion and pulmonary edema, which represent local or general fluid retention. These events appear to be dose related and are more common encountered in the elderly. However, there has been no report of hypersensitivity pneumonitis associated with imatinib-mesylate in Korea. We report a case of 51-year old woman who developed hypersensitivity pneumonitis that might have been induced by imatinib-mesylate during the treatment of a gastrointestinal stromal tumor.

Comparison of diagnostic performances of slow-pull suction and standard suction in endoscopic ultrasound-guided fine needle biopsy for gastrointestinal subepithelial tumors

  • Joon Seop Lee;Chang Min Cho;Yong Hwan Kwon;An Na Seo;Han Ik Bae;Man-Hoon Han
    • Clinical Endoscopy
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    • v.55 no.5
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    • pp.637-644
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    • 2022
  • Background/Aims: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is integral to the diagnosis of gastrointestinal (GI) subepithelial tumors (SETs). The impact of different EUS-FNB tissue sampling techniques on specimen adequacy and diagnostic accuracy in SETs has not been fully evaluated. This study aimed to compare the diagnostic outcomes of slow-pull (SP) and standard suction (SS) in patients with GI SETs. Methods: In this retrospective comparative study, 54 patients were enrolled. Medical records were reviewed for location and size of the target lesion, FNB needle type/size, technical order, specimen adequacy, diagnostic yield, and adverse events. The acquisition rate of adequate specimens and diagnostic accuracy were compared according to EUS-FNB techniques. Results: The mean lesion size was 42.6±36.4 mm, and most patients were diagnosed with GI stromal tumor (75.9%). The overall diagnostic accuracies of the SP and SS techniques were 83.3% and 81.5%, respectively (p=0.800). The rates of obtaining adequate core tissue were 79.6% and 75.9%, respectively (p=0.799). No significant clinical factors affected the rate of obtaining adequate core tissue, including lesion location and size, FNB needle size, and final diagnosis. Conclusions: SP and SS had comparable diagnostic accuracies and adequate core tissue acquisition for GI SETs via EUS-FNB.