Tipurile de vase asociate tumorilor GIST influenteaza eficienta terapiei antivasculare cu inhibitori de receptor tirozin-kinazic

Andrei Dan Korodi,Ada Maria Codreanu,Bogdan Socea,Nicolae Gheorghiu,Dragos Botezatu,Bogdan Totolici,Mihai Dimitriu,Diana Claudia Gheorghiu,Eftimie Miutescu,Cristian Furau,Ion Barbu,Gheorghe Furau,Alexandru Dumnici

doi:10.37358/rc.19.9.7528

Abstract

Gastrointestinal stromal tumors (GIST�sare the most common mesenchymal neoplasms of the alimentary tract. Angiogenesis is an essential condition in the growth and development of tumors, especially in the case of GISTs due to their particular behavior. The aggressive behavior depends on the size and site of the tumor in close relationship with the intratumoral vascular development. The purpose of this study is to investigate, using immunohistochemical stainings, the types of intratumoral vessels in GIST�s, knowing the interrelation between the tumor angiogenesis and the response to the targeted antivascular therapy, influencing directly the prognosis. In our research, in all 37 cases the most numerous vessels were the immature and intermediate ones, signaling an increased angiogenic activity. The perivascular cell free vessels are the most sensitive at antivascular therapy with tyrosine kinase receptor inhibitors, providing a good response and prognosis to the treatment. Immature vessels evaluation especially, could be a an important sign in assessment of the effectiveness of antivascular therapy in GIST.

Highlights

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the alimentary tract
In GIST carcinogenesis is involved a gain of excess function at the stem cell factor receptor, in the absence of ligand SCF, due to a mutation of proto-oncogene c-Kit located on chromosome arm 4q12 [20]
Extra-gastrointestinal stromal tumors (EGIST) are tumors developed outside the digestive tract

Summary

Introduction

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the alimentary tract. GISTs were regarded to be extremely rare, but as immunohistochemical studies have improved, much more cases were reported allowing to discover and understand the origin of the tumors, the molecular mechanism of carcinogenesis, the behavior according to the malignant potential and last but not the least the oncologic treatment including surgery and the therapy with biologic agents. All this findings have determined the distinction of GIST [3]. The tirozin t(k(rCCien22a8a2HHtsm2e227FFei3nNnNht47OiObo2)if)t,,oGdrssaIoSsrlaTiaktsfieneainibsmib(aaCt(di2Cnj2uH2ib1v2H6aC(1n6ClCNt2l97bFHO3i32No1SNl4)oO7Og3ui))cs,, enstduhilneoinirttaiintnphiiybbe, neoadjuvant therapy followed by surgery or in the treatmeant of metastatic disease are inhibiting CD117, PDGFRA and vascular endothelial growth factor receptors (VEGFRs), preventing tumorigenesis, due to the antiangiogenesis effect on the immature tumoral vessels [43-,46]

Objectives

Results

Conclusion