Gastrointestinalni stromalni tumor

master's thesis

• Title (english): Gastrointestinal stromal tumor
• Author: Ozren Veselić
• Mentor: Davor Tomas (mentor)
• Committee member: Majda Vučić (predsjednik povjerenstva)
• Committee member: Slavko Gašparov (član povjerenstva)
• Committee member: Davor Tomas (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pathology); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pathology

Abstract

Termin gastrointestinalni stromalni tumor prvi puta je upotrebljen 1983. godine kao naziv za gastrointestinalne tumore ne-epitelnog porijekla koji su bili imunohistokemijski negativni na markere za Schwannove stanice. Gastrointestinalni stromalni tumori (GIST) čine većinu mezenhimalnih tumora probavnog trakta. Njihova pojava najčešće je vezana uz mutaciju u c-KIT genu te manjim djelom uz mutaciju u platelet derived growth factor receptor alpha (PDGFRA) genu. Tumori nastaju iz intersticijalnih tzv. Cajalovih stanica. Javljaju se između 50.-70. godine života, nešto više u muškaraca (55%) nego u žena. Velik dio njih su mali tumori te se pronalaze slučajno dok oni veći uzrokuju razne simptome. Najčešći simptomi su pritisak i bol u abdomenu, krvarenje iz GI trakta, mučnina, te kod velikih tumora perforacija. Većina tumora, oko 60%, nastaje u želucu, oko 30% u tankom crijevu, a samo oko 5% se javlja u jednjaku i debelom crijevu. Dijagnoza se postavlja endoskopskim i radiološkim metodama, a potvrđuje patohistološkim pregledom uzorka tumora te imunohistokemijskom analizom pomoću markera CD117, CD34, dezmina i DOG1. Liječenje je operativno i medikamentozno. Mali tumori se uspješno operiraju, a veliki mogu biti samo djelomično operabilni te su skloni recidivima. Veliki tumori stvaraju i udaljene metastaze. Medikamentozno liječenje temelji se na inhibitorima mutacije c-kit tirozin kinaze (Imatinib-Glivec) te PDGFRA mutacije (Sunitinib). Prognoza ovisi o veličini tumora, atipiji stanica i broju mitoza, dubini invazije te prisutnosti metastaza.

Abstract (english)

The term gastrointestinal stromal tumor was first used in 1983 as a name for gastrointestinal tumors of non- epithelial origin who were negative for immunohistochemical markers for Schwann cells. Gastrointestinal stromal tumors (GIST) are the majority of mesenchymal tumors of the gastrointestinal tract. Their appearance is usually associated with a mutation in the c-KIT gene and in smaller part with a mutation in the platelet derived growth factor receptor alpha (PDGFRA) gene. Tumors are formed from the so-called interstitial Cajal's cells. They occur between 50 and 70 years of age, both in men and women. Much of them are small tumors and are found accidentally while the bigger ones cause various symptoms. The most common symptoms are pressure and pain in the abdomen, bleeding from the GI tract, nausea and in large tumors perforation. Most of the tumors, about 60%, occurs in the stomach, about 30% in the small intestine and only about 5% occurs in the esophagus and colon. Diagnosis is made by endoscopy and radiological methods confirmed by pathohistological examination of the tumor sample and by immunohistochemical analysis using CD117. Treatment is surgery and medication. Small tumors can successfully be operated, but large tumors can only be partially operable and are prone to recurrences. Large tumors can produce distant metastases. Medical treatment is based on inhibitors of c-kit mutation of tyrosine kinase (Imatinib Glivec), and PDGFRA mutations (Sunitinib). Prognosis depends on the size of the tumor, cell atypia, number of mitosis, the depth of invasion and the presence of metastasis.

• Keywords: GIST; c-kit mutacija; Cajalove stanice; patohistološka analiza; Glivec
• Keywords (english): GIST; c-kit mutation; Cajal's cells; pathohistological analysis; Glivec
• Language: croatian
• URN:NBN: urn:nbn:hr:105:238479
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-07-13 06:44:13