Chinese consensus on management of tyrosine kinase inhibitor-associated side effects in gastrointestinal stromal tumors.

Tyrosine kinase inhibitors (TKIs) have improved the overall survival of patients with gastrointestinal stromal tumors (GISTs), but their side effects can impact dose intensity and, consequently, the clinical benefit. To date, no guideline or consensus has been published on the TKI-associated adverse reactions. Therefore, the Chinese Society of Surgeons for Gastrointestinal Stromal Tumor of the Chinese Medical Doctor Association organized an expert panel discussion involving representatives from gastrointestinal surgery, medical oncology, cardiology, dermatology, nephrology, endocrinology, and ophthalmology to consider the systemic clinical symptoms, molecular and cellular mechanisms, and treatment recommendations of GISTs. Here, we present the resultant evidence- and experience-based consensus to guide the management of TKI-associated side events in clinical practice.

Sarcomatoid carcinoma of the stomach: A case report and literature review.

Sarcomatoid carcinoma of the stomach is a rare type of malignant tumor, characterized by distinct cellular morphology. This type of tumor is even more rare in giant size. The present study reports a case of giant sarcomatoid carcinoma, which developed in the distal stomach. A 49-year-old male underwent medical investigation for gastrointestinal hemorrhage. Endoscopic examination, computed tomography (CT) and positron emission tomography-CT scan identified a giant neoplasm, which involved the gastric antrum and body, gallbladder and hepatic flexure of the colon. Surgery was performed to excise the tumor, which was ~14×13×8 cm in size. A diagnosis of sarcomatoid carcinoma was made since the tumor was positive for epithelial markers, even within the mesenchymal elements. To the best of our knowledge, only 5 cases of sarcomatoid carcinoma of the stomach have been previously reported, and a tumor that has been able to be resected despite such a large size has never been reported.

Prognostic value of Ki67 index in gastrointestinal stromal tumors.

BACKGROUND: Ki67 index is one of the most important immunocytochemical markers of proliferation in tumors, but the criterion of Ki67 index in GISTs was not well-defined yet. Our study aims to fully evaluate the prognostic value of Ki67 index in GIST patients and efficiency of imatinib adjuvant therapy. METHODS: Clinicopathological data were confirmed by pathological diagnosis and clinical recorders. Recurrence-free survivals (RFS) were evaluated in 418 GIST patients (370 cases only taken the surgery and 48 high-risks taken imatinib adjuvant therapy after R0 resection). RESULTS: Two cutoff levels of Ki67 index (>5 and >8%) were established in our study through statistical analysis. Ki67 index (≤5, 6-8 and >8%) is an independent prognostic factor for RFS of GIST patients. Ki67 index>8% can precisely sub-divide high-risk GISTs effectively with different outcomes, and high-risk patients with Ki67 index>8% showed a poorer prognosis even with imatinib adjuvant therapy. CONCLUSION: Ki67 index is an effective complementation of modified NIH criteria in predicting the prognosis of GISTs, and Ki67 index>8% may act as an unfavorable factor for imatinib adjuvant therapy.

Variation in primary sequence and tandem repeat copy number among i-antigens of Ichthyophthirius multifiliis.

The immobilization antigens (i-antigens) of Ichthyophthirius multifiliis are potential vaccine candidates for the prevention of 'white spot' disease in freshwater fish. These antigens vary with respect to antigenicity and molecular mass, and at least five i-antigen serotypes have been identified among parasite isolates thus far. In previous studies, the gene and corresponding cDNA encoding a approximately 48 kDa i-antigen from parasite isolate G1 (serotype A), had been cloned and sequenced. We now report on the isolation of two new genes, designated IAG52A[G5] and IAG52B[G5], encoding approximately 52/55 kDa i-antigens from a parasite isolate representing a different serotype, namely, D. Based on their deduced sequences, the approximately 52/55 kDa gene products have the same structural features as the 48 kDa protein including hydrophobic N- and C-termini, periodic cysteine residues with the potential for metal binding, and tandemly repetitive amino acid sequence domains that span their length. Nevertheless, the products of these genes vary in their tandem repeat copy number, and share only approximately 50% homology overall. When expressed in heterologous systems, the products of the newly described genes react strongly with monospecific polyclonal antisera against the i-antigens of serotype D and are clearly i-antigens. It would nevertheless appear that mRNA transcripts from the two genes are present at widely different levels within parasites themselves. Analysis at the protein level using 2-D SDS-PAGE would further suggest that multiple i-antigens are expressed within the same serotype at any given time.