Asociación de hallazgos imagenológicos por tomografía computarizada y características histopatológicas en pacientes con tumores del estroma gastrointestinal (GIST) : un estudio de corte transversal en Méderi-Hospital Universitario Mayo
Thesis
Background: Gastrointestinal stromal tumors (GISTs) are uncommon mesenchymal tumors, which are located throughout the entire gastrointestinal tract. Its diagnosis is initially made by imaging studies such as endoscopic ultrasonography, computed tomography (CT), and/or magnetic resonance. The definitive diagnosis is made by the histopathological and immunohistochemical study. The treatment depends on the image and histopathological findings such as size, number of mitosis and immunohistochemistry. Methodology: Thirty patients were included with diagnosis of GISTs from Méderi - Mayor University Hospital. The period of time was January 2011 and April 2018. We looked for possible associations between the CT findings and the histopathology characteristics. Results: Different associations were found between the CT findings and the histopathological characteristics of the GISTs. A direct correlation (rho: 0.856) between the measurement of the tumor size, made by the pathologist and the radiologist (p: 0.001). Gastric tumors and the expression of the markers CD117 (p: 0.024) and CD 34 (p: 0.023). Association between gastric tumors and the absence of intratumoral blood vessels in CT (p: 0.036). The tumors with mixed growth pattern had a higher number of mitosis per high-power field (HPF) (p: 0.041). Tumors which did not express CD43 had higher enhancement after administration of contrast in CT (p: 0.032). Increased risk of disease progression was associated with increased enhancement measured by HU after administration of contrast in CT (p: 0.042). Conclusions: The tumors that showed higher enhancement after the administration of the contrast had greater risk of disease progression. The mixed tumor growth pattern by CT was associated with a higher number of mitoses, a factor associated with worse prognosis. Different associations were found between immunohistochemical markers and gastric tumors. Tumors CD34 negative was associated with a higher risk of progression, due to a higher enhancement in CT. This research leaves some radiological findings that could predict the behavior of the GISTs, for future investigations.
