V.N. DIOMIDOVA¹, A.N. DMITRIEVA^{1, 2}

 ¹Chivash State University named after I. N. Ulyanov, Cheboksary

²Republic Clinical Oncology Dispensary, Cheboksary

 Contact details:

Diomidova V.N. — MD, Head of the Department of Propedeutics of Internal Diseases with a course in radiation diagnostics

Address: 15 Moskovskiy prospekt, Russian Federation, Cheboksary, 428015, tel.: +7 (8352) 45-26-97, e-mail: [email protected]

 Gastrointestinal stromal tumor (GIST) is a malignant mesenchymal tumor originating from Cajal interstitial cells. It was distinguished as an independent nosological unit in the system of international classification of tumors only in 2000. The GIST prevalence is 11–14,5 per 100 thousand people. It is most often localized in the stomach, accounting for about 1% of all primary tumors of the stomach.

The purpose to study the incidence and character gastral lesions in the structure of GIST pathology in the Chuvash Republic (CR), to study the informative value of CT in the detection of gastric GIST.

Material and methods. An analysis of examination of patients with stromal tumors of the stomach according to the 2015–2018 materials of Republic Clinical Oncology Dispensary of the Ministry of Healthcare of Chuvash Republic.

Results. The main clinical manifestations of gastric GIST are considered. The characteristic CT signs of gastric GIST, including those depending on the size of the primary tumor, are presented.

Conclusions. At the preoperative stage, CT showed high levels of specificity (94,7%), sensitivity (97,2%), and accuracy (96,2%) in the detection of gastric GIST due to the presence of characteristic CT symptoms. At the preoperative stage, CT allows determining the organ belonging of the tumor, identifying the connection of the tumor to the stomach wall, assessing the prevalence of the process, the nature of growth, the presence of complications and distant metastases. CT allows surgeons to choose the optimal stage of surgical treatment, to avoid unnecessary lymph node dissections and volumous surgery.

Key words: gastrointestinal stromal tumors, multispiral computed tomography, stomach.

REFERENCES

1. Gastrointestinal’nye stromal’nye opukholi (diagnostika i lechenie): prakticheski rekomendatsii, pod red. prof. I.V. Poddubnoy [Gastrointestinal stromal tumors (diagnosis and treatment): practical recommendations, ed. prof. I.V. Poddubnaya]. Moscow, 2008.
2. Dubova E.A., Shchegolev A.I., Mishnev O.D., Karmazanovskiy G.G. Gastrointestinal stromal tumors (lecture). Med vizualizatsiya, 2007, no. 1, pp. 25–31 (in Russ.).
3. Nizyaeva N.V., Marey M.V., Sukhikh G.T., Shchegolev A.I. Interstitial pacemaker cells. Vestnik Rossiyskoy akademii meditsinskikh nauk, 2014, vol. 69, no. 7–8, pp. 17–24 (in Russ.).
4. Mazur M.T., Clark H.B. Gastric stromal tumors: reappraisal of histogenesis . Am J Surg Pathol, 1983, vol. 7, pp. 507–519.
5. Nikulin M.P., Sel’chuk V.Yu. Gastrointestinal stromal tumors: epidemiological data, approaches to treatment. RMZh. Prilozhenie. Onkologiya, 2010, vol. 1, no. 1, pp. 1-4 (in Russ.).
6. Strickland L., Letsdon G., MuroCacho C.A. Gastrointestinal stromal tumors. Cancer Control, 2001, vol. 8 (3), pp. 252–261.
7. Bogomolov N.I., Burdinskaya T.V., Goncharova M.A., Goncharov A.G., Tomskikh N.N. Features of diagnosis and treatment of stromal tumors of the gastrointestinal tract. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii, 2018, vol. 28, no. 3, pp. 45–53 (in Russ.).
8. Vetsheva N.N., Karmazanovskiy G.G., Stepanova Yu.A., Chzhao A.V. Features of radiation diagnosis of gastrointestinal stromal tumors. Meditsinskaya vizualizatsiya, 2013, no. 2, pp. 112–126 (in Russ.).
9. Bosman F.T., Carneiro F., Hruban R.H. et al. (eds.). WHO classification of tumours of the digestive system. Lyon: International Agency for Research on Cancer, 2010. 417 p.
10. Calabuig-Fariñas S., López-Guerrero J.A., Llombart-Bosch A. The paradigm of gastrointestinal stromal tumors: determination of diagnostic and prognostic criteria. Arkhiv patologii, 2011, vol. 73, no. 4, pp. 15–21 (in Russ.).
11. Corless C.L., Fletcher J.A., Heinrich M.C. Biology of gastrointestinal
    stromal tumors. J. Clin. Oncol, 2004, vol. 22 (18), pp. 3813–3825.
12. Agaimy A. Minute, Wunsch P.H., Hofstaedter F. Gastric sclerosing stromal tumors (GISTtumorlets) are common in adults and frequently show c-KIT mutations. Am. J. Surg. Pathol, 2007, vol. 31, pp. 113–120.
13. Joensuu Heikki. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Human pathology, 2008, vol. 39, pp. 1411–1419.
14. Akberov R.F., Zyyatdinov K.Sh., Mikhaylov M.K., Yakhin M.M., Nurgaliev R.G., Sakhapova L.R., Safiullina L.R., Diomidova V.N., Utkel’baev R.I. Kompleksnaya kliniko-luchevaya diagnostika zabolevaniy, funktsional’nykh narusheniy, porokov razvitiya i opukholevykh porazheniy pishchevoda, zheludka i piloroduodenal’noy zony [Complex clinical and radiation diagnostics of diseases, functional disorders, malformations and tumor lesions of the esophagus, stomach and pyloroduodenal zone]. Naberezhnye Chelny, 2010. 413 p.
15. Zagvozdkin E.S., Mershina E.A., Sinitsyn V.E. Radiation diagnostics of gastrointestinal stromal tumors. Luchevaya diagnostika i terapiya, 2013, vol. 2, no. 4, pp. 38–42 (in Russ.).
16. Diomidova V.N. Ultrasound angiography and assessment of tumor vascular invasion in gastric cancer. Vestnik Chuvashskogo universiteta, 2007, no. 2, pp. 72–78 (in Russ.).
17. Khalikov D.D., Akhmetzyanov F.Sh., Petrov S.V. Clinical and morphological characteristics of gastrointestinal stromal tumors. Arkhiv patologii, 2017, vol. 79, no. 4, pp. 48–55 (in Russ.).
18. Diomidova V.N. Visual characteristics of unchanged and operated stomach during ultrasound examination . Meditsinskaya vizualizatsiya, 2015, no. 4, pp. 46–55 (in Russ.).
19. Yurichev I.N., Burdyukov M.S., Nechipay A.M., Chistyakova O.V. Gastrointestinal stromal tumors: problems of diagnosis and treatment (literature review). Eksperimental’naya i klinicheskaya gastroenterologiya, 2012, no. 9, pp. 60–66 (in Russ.).
20. Klinicheskie rekomendatsii po lecheniyu GISO. Ministerstvo zdravookhraneniya RF. Peresmotr ot 2017 g. [Clinical guidelines for the treatment of GIST. Ministry of Health of the Russian Federation. Revision from 2017], available at: http://oncology-association.ru/files/clinical-guidelines_adults/giso.pdf
21. Kotlyarov P.M., Shaduri E.V., Vinikovetskaya A.V., Egorova E.V., Primak N.V. Luchevaya diagnostika gastrointestinal’nykh stromal’nykh opukholey. Vestnik Rossiyskogo nauchnogo tsentra rentgenoradiologii MZ RF, 2012, no. 12-1, p. 16 (in Russ.).
22. Lokshina A.A., Semenov I.I., Gafton G.I., Zhabina A.S., Lazareva Yu.R.
    The role of computed tomography in the diagnosis of gastrointestinal stromal tumors. Voprosy onkologii, 2011, vol. 57, no. 6, pp. 727–730 (in Russ.).
23. Solodkiy A.V. Gastrointestinal’nye stromal’nye opukholi. Diagnostika i khirurgicheskoe lechenie: avtoref. dis… kand. med. nauk [Gastrointestinal stromal tumors. Diagnostics and surgical treatment. Synopsis of dis. PhD med. sciences]. Moscow, 2013.
24. Sergacheva A.S. Gastrointestinal stromal tumors: concept, prevalence in the Russian Federation and the Republic of Mordovia. Ogarev-Online, 2018, no. 4 (109), p. 8 (in Russ.).
25. Tsymzhitova N.Ts-D. Kompleksnaya luchevaya i endoskopicheskaya diagnostika gastrointestinal’nykh stromal’nykh opukholey: avtoref. dis … kand. med. nauk [Complex radiation and endoscopic diagnostics of gastrointestinal stromal tumors. Synopsis of dis. PhD med. sciences].