Is a “wait-and-see” policy the best for small gastric gastrointestinal stromal tumor (GIST)?

Kanda, Tatsuo

doi:10.21037/tgh.2016.01.06

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…Next, we sought to further investigate the ability of crExos GPC1 to diagnose PDAC. Several authors have asked for the results from Melo et al [ 12 ] to be confirmed in an independent series of patients [ 16 , 17 ]. These additional data would help to validate crExos GPC1 as a blood-based biomarker for the detection of PDAC [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Glypican-1 is enriched in circulating-exosomes in pancreatic cancer and correlates with tumor burden

et al. 2018

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BackgroundGlypican-1 (GPC1) is expressed in pancreatic ductal adenocarcinoma (PDAC) cells and adjacent stromal fibroblasts. Recently, GPC1 circulating exosomes (crExos) have been shown to be able to detect early stages of PDAC. In this study, we investigated the usefulness of crExos GPC1 as a biomarker for PDAC.MethodsPlasma was obtained from patients with benign pancreatic disease (n = 16) and PDAC (n = 27) prior to pancreatectomy, and crExos were isolated by ultra-centrifugation. Protein was extracted from surgical specimens (adjacent normal pancreas, n = 13; and PDAC, n = 17). GPC1 levels were measured using enzyme-linked immunosorbent assay (ELISA).ResultsThere was no significant difference in GPC1 levels between normal pancreas and PDAC tissues. This was also true when comparing matched pairs. However, GPC1 levels were enriched in PDAC crExos (n = 11), compared to the source tumors (n = 11; 97 ± 54 vs. 20.9 ± 12.3 pg/mL; P < 0.001). In addition, PDACs with high GPC1 expression tended to have crExos with higher GPC1 levels. Despite these findings, we were unable to distinguish PDAC from benign pancreatic disease using crExos GPC1 levels. Interestingly, we found that in matched pre and post-operative plasma samples there was a significant drop in crExos GPC1 levels after surgical resection for PDAC (n = 11 vs. 11; 97 ± 54 vs. 77.8 ± 32.4 pg/mL; P = 0.0428). Furthermore, we found that patients with high crExos GPC1 levels have significantly larger PDACs (>4 cm; P = 0.012).ConclusionsHigh GPC1 crExos may be able to determine PDAC tumor size and disease burden. However, further efforts are needed to elucidate its role as a diagnostic and/or prognostic biomarker using larger cohorts of PDAC patients.

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Section: Discussionmentioning

confidence: 99%

Glypican-1 is enriched in circulating-exosomes in pancreatic cancer and correlates with tumor burden

et al. 2018

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“…In our study, there were 17 intermediate/high-risk patients (6.2%). Thus, screening out patients with intermediate/high-risk cases of small gGIST is still a clinical challenge (10,21).…”

Section: Discussionmentioning

confidence: 99%

Which size is the best cutoff for primary small gastric gastrointestinal stromal tumor?

Feng¹,

Yang²,

Zhang³

et al. 2020

J Gastrointest Oncol

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Background: The biological behavior of primary small gastric gastrointestinal stromal tumor (gGIST) is indolent. The cutoff size categorizing small gGIST continues to be controversial. To date, there is no consensus regarding whether it should be 1 cm, 2 cm, or another size. We aimed to find a new cutoff size.Methods: Retrospective clinicopathological and prognosis data of patients with small gGIST from January 1998 to January 2015 were collected among five medical centers in southern China. Tumor size was divided into two groups: <1 cm (Mirco group) and 1-2 cm (Small group). We compared the clinicopathological index and prognosis between these two groups and identified a new cutoff size to define small gGIST.Results: During this 18-year period, there were 276 patients with primary small gGIST treated at these five medical centers. The range of tumor size was 0.2-2.0 cm. The median tumor size was 1.0 cm. The range of the mitotic count was 0-70/50 high power fields (HPFs) with counts ≤5/50 HPFs in 259 patients (93.8%), 5< counts ≤10/50 HPFs in 7 patients (2.5%), and counts >10/50 HPFs in 10 patients (3.6%). The median follow-up time was 38 months (3-156 months). The 5-year overall survival rate was 98.7% in the entire group. Using Pearson correlation analysis, there was a positive correlation between the mitotic count and tumor size as a continuous variable (r=0.164, P=0.006). There were 137 patients in the Micro group and 139 cases in the Small group. In the Micro group, mitotic counts were ≤5/50 HPFs in 134 patients, 5< counts ≤10/50 HPFs in 0 patients, and counts >10/50 HPFs in 3 patients; mitotic counts in the Small group were counts ≤5/50 HPFs in 125 patients, 5< counts ≤10/50 HPFs in 7 patients, >10/50 HPFs in 7 patients.There was a statistically significant difference between these two groups (P=0.002); the Small group had more intermediate/high-risk cases. Using the receiver operating characteristic curve (ROC curve), we observed that 1.15 cm was the new cutoff size to separate low-risk cases and intermediate/high-risk cases (AUC =0.707, P=0.004, sensitivity =0.824, 1-specificity =0.429).Conclusions: Primary small gGIST has a good prognosis; gGIST <1 cm can be regarded as benign tumors that only requires endoscopic ultrasonography (EUS) follow-up. The proportion of potential intermediate/ high-risk disease is high for patients with 1-2 cm gGIST. These patients should be treated with caution and the tumors should be resected if necessary. These results indicate that 1.15 cm may be the new cutoff size to separate small gGIST from large gGIST, but further studies are needed for verification.

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Clinicopathological features and prognosis of 276 cases of primary small (≤ 2 cm) gastric gastrointestinal stromal tumors: a multicenter data review

et al. 2018

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Is a “wait-and-see” policy the best for small gastric gastrointestinal stromal tumor (GIST)?

Cited by 3 publications

References 16 publications

Glypican-1 is enriched in circulating-exosomes in pancreatic cancer and correlates with tumor burden

Glypican-1 is enriched in circulating-exosomes in pancreatic cancer and correlates with tumor burden

Which size is the best cutoff for primary small gastric gastrointestinal stromal tumor?

Clinicopathological features and prognosis of 276 cases of primary small (≤ 2 cm) gastric gastrointestinal stromal tumors: a multicenter data review

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