Introduction: The differentiation of digestive tumors very often requires the use of techniques currently not widely in use in the Democratic Republic of Congo (DRC), such as immunohistochemistry. This is perfectly ve...Introduction: The differentiation of digestive tumors very often requires the use of techniques currently not widely in use in the Democratic Republic of Congo (DRC), such as immunohistochemistry. This is perfectly verified for GISTs whose precise, or at least highly certain, diagnosis can only be made using immunohistochemical markers. This underuse of these techniques due to lack of equipment and human skills explains the limited epidemiological data available to date, thus leading to untargeted and too often late treatment of patients. Research question: What contribution can immunohistochemical markers make to the diagnosis of digestive tract tumours? Objective: Discuss the contribution of immunohistochemical markers in the diagnosis of GIST and provide basic data on the epidemiology of these nosological entities in Kinshasa. Methodology: This was a retrospective study carried out at the LEBOMA private anatomy and pathological cytology centre. The main inclusion criterion was any digestive tract block or slide whose diagnosis of GIST had been requalified after review by at least 2 pathologists. An immuhistochemical study was performed using an automated technique (with a Ventana XT machine) using a panel of antibodies: CD-117 and DOG-1 which are listed in the literature as strongly correlated with the occurrence of GIST, all slides were made at Hj Hospital using an OLYMPUS BX41 co-observation microscope. Results: Of 601 cases of digestive tumors recorded during the concerned period, 32 (5.32%) concerned GIST. This prevalence was confirmed by our immunohistochemical results where the expression of CD117 and that of DOG-1 were positive in 90.6% and 100% of cases which prevalence is high compared with the worldwide prevalence according to the literature, respectively. The distribution of the patients concerned was made with a sex ratio of 1.6 women/men with a median age of 53 years. Most cases (81%) had a gastric location and were fusiform GISTs. Conclusion: Gastrointestinal stromal tumours, although rare and underestimated, account for 5.32% of cases in the DRC. This is a considerable and high prevalence compared with the world average. To the best of our knowledge, no studies have been carried out on these aspects in the DRC, which explains the importance of this study. The results of this research demonstrated the contribution of these 2 markers as specific and effective biomarkers for optimal and differential diagnosis in GIST. In view of the above, it is therefore more than necessary to popularise the use of these biomarkers in order to contribute effectively to improving the overall management of gastrointestinal tumours by improving their identification.展开更多
Introduction: Primary extra-gastrointestinal stromal tumors (E-GIST) of the liver are rare. The clinical presentation can range from asymptomatic to bleeding or manifestations of mass effect. Cancer surgery followed b...Introduction: Primary extra-gastrointestinal stromal tumors (E-GIST) of the liver are rare. The clinical presentation can range from asymptomatic to bleeding or manifestations of mass effect. Cancer surgery followed by adjuvant treatment with imatinib is the standard of care. However, in special circumstances, a cytoreductive approach may represent a therapeutic option. We describe here the case of two patients who presented with a painful and protruding epigastric mass, the first case was a localized E-GIST candidate for neoadjuvant treatment with imatinib with complete resection surgery thereafter with very good evolution, and the second is that of an E-GIST of the liver at an advanced stage with an evolution very quick to death. Conclusion: Primary liver E-GIST is a rare condition. Treatment is based on systemic therapy and total resection surgery. However, cytoreductive surgery will be required when complete resection is not possible.展开更多
DOG1(discovered on GIST 1)是由人类11q13所编码的8次穿膜蛋白,是一种钙离子激活的氯离子通道。DOG1广泛表达于多种人体组织中,该蛋白可能与一系列生理学过程如细胞分泌,心脏和神经元兴奋,感觉换能,肠道cajal细胞的兴奋,受精过程等有关...DOG1(discovered on GIST 1)是由人类11q13所编码的8次穿膜蛋白,是一种钙离子激活的氯离子通道。DOG1广泛表达于多种人体组织中,该蛋白可能与一系列生理学过程如细胞分泌,心脏和神经元兴奋,感觉换能,肠道cajal细胞的兴奋,受精过程等有关。DOG1高表达于胃肠间质瘤(gastrointestinal stromal tumors GIST),联合CD117、CD34和PDG-FRA在GIST的诊断和鉴别诊断中的应用,大大提高了其诊断率,是一种敏感和特异的GIST标记物。展开更多
文摘Introduction: The differentiation of digestive tumors very often requires the use of techniques currently not widely in use in the Democratic Republic of Congo (DRC), such as immunohistochemistry. This is perfectly verified for GISTs whose precise, or at least highly certain, diagnosis can only be made using immunohistochemical markers. This underuse of these techniques due to lack of equipment and human skills explains the limited epidemiological data available to date, thus leading to untargeted and too often late treatment of patients. Research question: What contribution can immunohistochemical markers make to the diagnosis of digestive tract tumours? Objective: Discuss the contribution of immunohistochemical markers in the diagnosis of GIST and provide basic data on the epidemiology of these nosological entities in Kinshasa. Methodology: This was a retrospective study carried out at the LEBOMA private anatomy and pathological cytology centre. The main inclusion criterion was any digestive tract block or slide whose diagnosis of GIST had been requalified after review by at least 2 pathologists. An immuhistochemical study was performed using an automated technique (with a Ventana XT machine) using a panel of antibodies: CD-117 and DOG-1 which are listed in the literature as strongly correlated with the occurrence of GIST, all slides were made at Hj Hospital using an OLYMPUS BX41 co-observation microscope. Results: Of 601 cases of digestive tumors recorded during the concerned period, 32 (5.32%) concerned GIST. This prevalence was confirmed by our immunohistochemical results where the expression of CD117 and that of DOG-1 were positive in 90.6% and 100% of cases which prevalence is high compared with the worldwide prevalence according to the literature, respectively. The distribution of the patients concerned was made with a sex ratio of 1.6 women/men with a median age of 53 years. Most cases (81%) had a gastric location and were fusiform GISTs. Conclusion: Gastrointestinal stromal tumours, although rare and underestimated, account for 5.32% of cases in the DRC. This is a considerable and high prevalence compared with the world average. To the best of our knowledge, no studies have been carried out on these aspects in the DRC, which explains the importance of this study. The results of this research demonstrated the contribution of these 2 markers as specific and effective biomarkers for optimal and differential diagnosis in GIST. In view of the above, it is therefore more than necessary to popularise the use of these biomarkers in order to contribute effectively to improving the overall management of gastrointestinal tumours by improving their identification.
文摘Introduction: Primary extra-gastrointestinal stromal tumors (E-GIST) of the liver are rare. The clinical presentation can range from asymptomatic to bleeding or manifestations of mass effect. Cancer surgery followed by adjuvant treatment with imatinib is the standard of care. However, in special circumstances, a cytoreductive approach may represent a therapeutic option. We describe here the case of two patients who presented with a painful and protruding epigastric mass, the first case was a localized E-GIST candidate for neoadjuvant treatment with imatinib with complete resection surgery thereafter with very good evolution, and the second is that of an E-GIST of the liver at an advanced stage with an evolution very quick to death. Conclusion: Primary liver E-GIST is a rare condition. Treatment is based on systemic therapy and total resection surgery. However, cytoreductive surgery will be required when complete resection is not possible.
