• Nuclear Medicine and Molecular Imaging
• /
• 제42권sup1호
• /
• pp.46-51
• /
• 2008

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasm of the gastrointestinal tract, and can be distinguished from the smooth muscle or neural tumors in approximately 95% of patients by expression of the KIT receptor tyrosine kinase (CD117). GISTs are known to have high malignant potential and none can be labeled definitely as benign. However, GISTs are unresponsive to standard sarcoma chemotherapy, and only complete surgical resection provides chance for cure. Although the imaging modality of choice is enhanced CT scan in patients with GIST, FDG PET can reflect the malignant potential of GIST. Clinical management of patients with GISTs has dramatically changed with the introduction of novel therapeutics, such as imatinib mesylate (Glivec). This has created a need to re-evaluate the existing criteria used to assess treatment response. FDG PET as functional imaging modality proved to be significantly more accurate than CT alone when assessing GIST response to imatinib. And, FDG PET and PET ICT have been found to be highly sensitive in detecting early response, and to be useful in predicting long-term response to imatinib in patients with recurrent or metastatic GISTs.

• Clinical Endoscopy
• /
• 제57권3호
• /
• pp.329-331
• /
• 2024

• Journal of Gastric Cancer
• /
• 제7권4호
• /
• pp.254-260
• /
• 2007

목적: 위와 소장에 발생한 위장관 간질종양의 임상병리학적 특징을 비교하여 예후 인자 및 적절한 치료의 방침을 알아보고자 하였다. 대상 및 방법: 대진의료재단 분당제생병원에서 1998년 8월부터 2006년 5월까지 위장관 간질종양으로 진단된 38명의 환자 중 분석 및 추적 조사가 가능했던 29명의 환자에서 임상 양상을 조사하고, 면역조직화학적 염색을 시행하였으며, NIH 합의안에 따라 위험도를 분류하여 각각 위와 소장에서 발생한 위장관 간질종양을 비교하였다. 결과: 위와 소장에 발생한 위장관 간질종양의 임상병리학 적 차이 및 재발 양상의 차이는 없었으며, NIH 위험도 분류에 따라 나눈 고위험군과 저위험군 간에 재발의 차이는 있었다(P=0.030). 결론: 위장관 간질종양에서 원발 부위인 위와 소장간에 임상병리학적 양상이나 예후에 통계학적으로 유의한 차이는 없었으나, NIH 분류에 의한 고위험군에서는 재발 가능성이 높으므로 치료 지침에 따른 적절한 추적관찰이 필요하며, 앞으로 여러 기관의 예를 통합한 큰 모집단을 대상으로 지속적인 연구를 시행하여 국내 실정에 맞는 정확한 진단 기준 및 치료지침이 만들어져야 될 것으로 사료된다.

• Journal of Gastric Cancer
• /
• 제15권4호
• /
• pp.290-294
• /
• 2015

C-kit-negative gastrointestinal stromal tumors (GISTs) are uncommon, and there have been few reports about the diagnosis and treatment of c-kit-negative GISTs in the stomach. We report the case of a patient who was diagnosed with a huge and atypical GIST in the stomach. The GIST was completely resected and finally diagnosed as c-kit-negative GIST based on immunohistochemical staining of tumor cells, which were negative for CD117 and CD34 and positive for Discovered on GIST-1 (DOG1). C-kit-negative GISTs could be treated by complete resection and/or imatinib, which is the same treatment for c-kit-positive GISTs.

• 항공우주의학회지
• /
• 제30권2호
• /
• pp.80-82
• /
• 2020

Gastrointestinal Stromal Tumors (GISTs) are relatively uncommon soft tissue sarcomas that can be located in any part of the digestive system. GISTs originate in specialized nerve cells located in the walls of the digestive system. This case report is about a 53-year-old airman who was recently diagnosed as peritoneal GISTs. He got a surgical removal of the tumor and chemotherapy, including imatinib (Gleevec^®). Although his GISTs have shown excellent clinical progress, he still needs ongoing treatment. This case involves an airline pilot applicant for Class-I medical certification who has had GISTs under chemotherapy.

• Journal of Gastric Cancer
• /
• 제1권1호
• /
• pp.50-54
• /
• 2001

Purpose: The aim of this study was to analyze the outcomes of patients with gastrointestinal stromal tumors(GISTs) of the stomach who were treated in our hospital. Materials and Methods: We retrospectively studied 31 patients who were treated for primary gastrointestinal stromal tumors of the stomach from 1990 to 1999 at Korea University Guro Hospital. Clinical characteristics, including age, sex and tumor size were analyzed. In addition, the relation between the 5-year survival rate and tumor size, operative procedure, and malignancy were analyzed to identify the factors that predict survival. Results: The malignant GISTs were 11 cases, borderline GISTs were 2 cases, and benign GISTs were 18 cases. The overall 5-year cumulative survival rate of the patients was $84.6\%$, and the 5-year survival rates according to malignancy were $100\%$ for benign and borderline GISTs and $78.1\%$ for malignant GISTs, p=0.1119. The 5-year survival rates according to tumor size were $100\%$ for tumor sizes smaller than 5 cm and $78.4\%$ for tumor sizes larger than 5 cm, p=0.0453. The 5-year survival rate according to lymph node dissection during operative procedure of malignant GISTs was not significant statistically. Conclusions: GISTs of the stomach are infrequently encountered tumors. Tumor size was the most important factor for predicting survival in a clinical situation, and performing a complete resection of the tumor, especially tumors larger than 5 cm, will improve the outcome of treatment.

• Journal of Digestive Cancer Research
• /
• 제3권1호
• /
• pp.21-25
• /
• 2015

Gastric neuroendocrine tumors (GNETs, also known as gastric carcinoids) are rare form of hormone-secreting neoplasms that present with varied clinical syndromes. There are four types of GNETs based on size, proliferation, localization, differentiation, and hormone production. Type I GNET is related to autoimmune atrophic gastritis and hypergastrinemia. Type II GNETs are related to multiple endocrine neoplasia (MEN)-1, Zollinger-Ellison syndrome and hypergastrinemia. Type 3 GNETs are not associated with any background pathology, and type 4 GNETs are poorly differentiated tumors. The most useful diagnostic and prognostic marker for gastrointestinal NETs is plasma chromogranin A (CgA) levels. Endoscopic ultrasound is the method of choice to determine tumor size and depth of infiltration. For optimal management, the type, biology, and stage of the tumor must be considered. Here, we provide a comprehensive and up-to-date review of GNETs.

• Clinical Endoscopy
• /
• 제56권5호
• /
• pp.546-552
• /
• 2023

Techniques for upper gastrointestinal endoscopy are advancing to facilitate lesion detection and improve prognosis. However, most early tumors in the upper gastrointestinal tract exhibit subtle color changes or morphological features that are difficult to detect using white light imaging. Linked color imaging (LCI) has been developed to overcome these shortcomings; it expands or reduces color information to clarify color differences, thereby facilitating the detection and observation of lesions. This article summarizes the characteristics of LCI and advances in LCI-related research in the upper gastrointestinal tract field.

• Journal of Yeungnam Medical Science
• /
• 제30권2호
• /
• pp.105-108
• /
• 2013

Type 1 neurofibromatosis (von Recklinghausen's disease, NF-1) is an autosomal-dominant neurocutaneous-disorder characterized by systemic cafe'-au-lait spots, multiple cutaneous neurofibromas, axillary or inguinal freckling, and Lisch nodules (pigmented iris hamartomas). Approximately 10-25% of NF1 patients have gastrointestinal neoplasms. Gastrointestinal stromal tumor (GIST) in patients with neurofibromatosis is most commonly found in the small bowel and the stomach, and approximately 60% of such patients have multiple tumors or multiple tumor sites. Although, the increased incidence of GIST in patients with neurofibromatosis is well documented in pathology literature in English, but has rarely been documented in Korea. Here, we report a case of multiple GISTs in a 48-year-old woman accompanied by NF1. She was admitted to Yeung-nam University Hospital with complaints of melena and dyspnea. A contrast-enhanced computed tomography (CT) scan revealed that multiple soft tissue masses were occupying the entire peritoneal cavity. An ultrasonogram- guided biopsy was performed and the tumors were found to have been composed of tumor cells that were positive for c-kit protein. The patient was put on Imatinib mesylate treatment, and further follow-up will be carried out.

• Journal of Digestive Cancer Research
• /
• 제2권1호
• /
• pp.1-4
• /
• 2014

Palliative care for cancer aims to relieve the discomfort and pain from the cancer itself and associated conditions. Gastrointestinal cancers originate from the tube like structure of gastrointestinal tract and cause complications such as obstruction, bleeding, adhesion, invasion, and perforation to adjacent organ. Recent advances in interventional endoscopy enables endoscopy physicians to do safe and effective care for gastrointestinal cancer patients. Endoscopic palliation includes stent, hemostasis, nutritional support and targeted drug delivery. Self expandable metallic stent is one of the most important modalities in gastrointestinal palliation. Through the endoscopy or over the wire pre-placed by endoscopy, stents restore the gastrointestinal luminal patency and relieve the obstructive condition. Endoscopic hemostasis is another important palliation in gastrointestinal cancer patients. Epinephrine injection, argon plasma coagulation and thermal cauterization are usual modalities for hemostasis. Histoacryl glue and fibrin glue are also available. Hemostatic nanopowder spray is newly reported effective in benign disease and is supposed to be effective also in cancer bleeding. Enteral feeding tubes including gastro- or jejunostomy and nosoduodenal tubes are placed by using endoscopic guidance. Enteral feeding tubes role as the route of easily absorbable or semi-digested nutrients and effectively maintain both patients calorie requirements and gut microenvironment. Photodynamic therapy is the one of the outstanding medical employments of photo-physics. Especially for superficial cancers in esophagus, photodynamic therapy is very useful in cancer removal and maintaining organ structure. In biliary neoplasm, photodynamic therapy is well known to be effective in cancer ablation and biliary ductal patency restoration. Targeted drug delivery is the lastest issue in palliative endoscopy. Debates and questions are still on the table. In this article, the role of endoscopic interventions in palliative care for the gastrointestinal tumors will be thoroughly reviewed.