A Gastrointestinal Stromal Tumor of the Stomach Demonstrating a Stepwise Progression from Low- to High-Grade Malignancy

Nakajima, Takahiko; Ushijima, T.; Kihara, Atsushi; Murata, Kenichiro; Sugiyama, Toshiro; Tsuneyama, Koichi; Imura, Johji; Fukushima, Junichi; Horiuchi, Hajime

doi:10.1155/2012/606832

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…If the size remains constant, the intervals can probably be extended in the elderly. Interestingly to note, rapid progression of a gastric GIST that had stayed stable at a size of 1.8 cm for 8 years has been reported [29] . If initial cytohistological assessment of early gastric GIST has not been performed or has not been conclusive and if there is strong clinical suspicion of early GIST, endoscopic ultrasound of the stomach should be repeated already after an interval of 2-3 mo.…”

Section: Endoscopic Surveillancementioning

confidence: 95%

Management of early asymptomatic gastrointestinal stromal tumors of the stomach

Scherübl

Faiss

Knoefel

et al. 2014

WJGE

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Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. Approximately two thirds of clinically manifest tumors occur in the stomach, nearly one third in the small bowel, and the rest in the colorectal region with a few cases in the esophagus. GIST originate within the smooth muscle layer in the wall of the tubular gastrointestinal tract and grow mostly toward the serosa, far less often toward the mucosa. In the latter case, ulceration may develop and can cause gastrointestinal bleeding as the cardinal symptom. However, most GIST of the stomach are asymptomatic. They are increasingly detected incidentally as small intramural or submucosal tumors during endoscopy and particularly during endoscopic ultrasound. Epidemiological and molecular genetic findings suggest that early asymptomatic GIST of the stomach (< 1 cm) show self-limiting tumorigenesis. Thus, early (< 1 cm) asymptomatic gastric GIST (synonym: micro-GIST) are found in 20%-30% of the elderly. The mostly elderly people with early gastric GIST have an excellent GIST-specific prognosis. Patients with early GIST of the stomach can therefore be managed by endoscopic surveillance.

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Section: Endoscopic Surveillancementioning

confidence: 95%

Management of early asymptomatic gastrointestinal stromal tumors of the stomach

Scherübl

Faiss

Knoefel

et al. 2014

WJGE

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“…Undoubtedly, the mitotic rate and tumor size, which are powerful prognostic indicators for the risk assessment of GIST, are still key factors to distinguish different degrees of malignancy for those tumors with same locations. Additionally, as reported in previous study, gastric GIST have become malignant progression from preexisting less aggressive tumors, namely a stepwise progression from low- to high-grade malignancy [ 10 ]. The metastasis rate or tumor-related mortality for gastric GIST with tumor size ≤2 cm and mitotic rate ≤ 5 mitoses/50 HPFs and those with tumor size > 10 cm and mitotic rate > 5 mitoses/50 HPFs are 0.0 and 86.0%, respectively, according to the NCCN guidelines (Version 2.…”

Section: Introductionmentioning

confidence: 82%

Secreted protein acidic and rich in cysteine-like 1 suppresses metastasis in gastric stromal tumors

et al. 2018

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BackgroundMalignant growth and metastasis of gastrointestinal stromal tumors (GIST) occur in some patients even during the course of treatment, but their mechanisms remains poorly understand at the molecular level so far.MethodsProfiles of protein expression in gastric GIST tissues were explored using protein microarray analysis, down-regulation of SPARCL1 (secreted protein acidic and rich in cysteine-like protein 1) was validated by RT-qPCR, western blot and immunohistochemistry. The effect of specific shRNA-induced SPARCL1 downregulation on the biological traits of GIST 882 cell was investigated. We then employed a mouse xenograft model to investigate whether the low-expression of SPARCL1 impact the metastasis ability of GIST cells in vivo.ResultsSPARCL1 was significantly downregulated in the gastric GIST with high-grade malignance as compared with low-grade malignance, its expression was closely correlated with tumor size, mitotic index, distant metastasis at the time of initial diagnosis and tumor progression of GIST (P < 0.05). Moreover, results of the Cox analysis showed that expression of SPARCL1 is an independent prognostic predictors for gastric GIST (P = 0.008; HR 0.157, 95% CI 0.040~ 0.612). Downregulation of SPARCL1 promoted cell migration and invasion, but did not affect proliferation, cell cycle and apoptosis of GIST 882 cells. In mouse xenograft model, GIST cells with the decreased expression of SPARCL1 presented an enhanced ability of liver metastasis (P < 0.05).ConclusionsTaken together, our present study demonstrated that SPARCL1 have a certain degree of malignancy-suppressing potential through inhibiting the metastasis of gastric GIST.Electronic supplementary materialThe online version of this article (10.1186/s12876-018-0833-8) contains supplementary material, which is available to authorized users.

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“…[ 178 ] Most guidelines consider a conservative follow-up by EUS every 6–12 months acceptable. [ 174 175 177 179 180 181 ] However, there is some evidence for a malignant potential of even small GISTs[ 182 183 ] in favor of resection of all gastrointestinal GISTs irrespective of size. [ 180 181 183 ] Therefore, patients should be informed about the possibility of malignancy, even if the tumor is small.…”

Section: Subepithelial Lesionsmentioning

confidence: 99%

Controversies in EUS: Do we need miniprobes?

et al. 2021

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This is the fifth in a series of papers entitled “Controversies in EUS.” In the current paper, we deal with high-resolution catheter probes, otherwise known as EUS miniprobes (EUS-MPs). The application of miniprobes for early carcinomas in the entire intestinal tract, for subepithelial lesions, and for findings in the bile duct and pancreatic duct as well as endobronchial use is critically discussed. Submucous lesions, especially in the colon, but also early carcinomas in special cases are considered the most important indications. The argument is illustrated by numerous examples.

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A Gastrointestinal Stromal Tumor of the Stomach Demonstrating a Stepwise Progression from Low- to High-Grade Malignancy

Cited by 4 publications

References 9 publications

Management of early asymptomatic gastrointestinal stromal tumors of the stomach

Management of early asymptomatic gastrointestinal stromal tumors of the stomach

Secreted protein acidic and rich in cysteine-like 1 suppresses metastasis in gastric stromal tumors

Controversies in EUS: Do we need miniprobes?

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