Mehmet Ali GÖK, Serkan Fatih YEĞEN, Mehmet Tolga KAFADAR, Aytaç Emre KOCAOĞLU

Gastrointestinal Stromal Tümörlerde İmmünohistokimyasal Markırların ve Tümör Boyutunun Prognoz Üzerindeki Rolü

Giriş: Gastrointestinal stromal tümörlerin tanısında genel itibariyle immünohistokimyasal boyanma yöntemleri kullanılmktadır. Bu çalışmanın amacı bu parametreler haricinde immünohistokimyasal boyanma özelliklerinin risk gruplarının belirlenmesindeki yerini saptamaktır. Yöntem: 2008-2019 yılları arasında genel cerrahi kliniğine başvuran 66 hasta çalışmaya dahil edildi ve dosyaları geriye dönük olarak tarandı. Yaş, cinsiyet, klinik prezentasyon, tümör boyutları, patolojik verileri, mitotik indeksi parametreleri değerlendirildi. Bulgular: GİST tanısı almış 66 hastada kadın/erkek oranı 31/55 olup, yaş ortalaması 62 idi. Tümör lokalizasyonlarına bakıldığında en sık mide ve ince barsak lokalizasyonu saptandı. Hastaların patoloji sonuçlarının immünohistokimyasal olarak incelenmesini takiben hastaların tümünde CD117’nin pozitif ve desmin’nin negatif olarak boyandığı saptandı. Maximum tümör çapı 40 cm, minimum tümör çapı 6 cm, ortalama tümör çapı 13.9 cm olarak saptandı. ortalama mitotik indeks 14.1 olarak saptandı. Sonuç: Tümör karakteresteğinin net olarak anlaşılamadığı ve zaman içinde bu karakterestiğin modifiye olduğu göz önünde bulundurulursa tanıya yardımcı ve tedavide yol gösterici parametrelerin önemi daha iyi anlaşılmaktadır. Yapılmakta olan ve yapılacak olan çalışmalar prognoz ve survi tahmininde yeni ve spesifik kriterlerin bulunacağını, bulunması gerektiğini düşünmekteyiz.

The Role of Immunohistochemical Markers and Tumor Size on Prognosis in Gastrointestinal Stromal Tumors

Objective: Immunohistochemical staining methods are generally used in the diagnosis of gastrointestinal stromal tumors. Apart from these parameters, immunohistochemical staining characteristics are determined in determining the risk groups. Method: In the 2008-2019 study, 66 patients who applied to the general surgery clinic were followed up and their files were scanned retrospectively. Age, gender, clinical presentation, tumor extinguishing, pathological purpose, mitotic index were evaluated. Results: The ratio of women / men with a diagnosis of GIST was 31/55, and the mean age was 62. When tumor localizations were examined, the most common localization was found to be stomach and small intestine. Following the immunohistochemical examination of the pathology results of the patients, it was found that CD117 was stained as positive and desmin was negative in all of them. The maximum tumor diameter was 40 cm, the minimum tumor diameter was 6 cm, and the mean diameter was 13.9 cm. the mean mitotic index was determined as 14.1. Conclusion: Considering that the tumor characteristic is not clearly understood and this characteristic has been modified over time, the importance of diagnostic and guiding parameters in treatment is better understood. We think that new and specific criteria will be found in the prognosis and survival prediction of the studies that are being done and to be done.

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