Gastrointestinal Stromal Tümörlerde Histopatolojik ve Hematolojik Belirteçlerin Prognostik Rolü

Year 2025, Volume: 8 Issue: 3, 287 - 294, 22.10.2025

Adem Şentürk , Emre Gönüllü , Alp Ömer Cantürk , Ahmet Tarık Harmantepe , Recayi Capoglu , Fuldem Mutlu

https://doi.org/10.53446/actamednicomedia.1677338

Abstract

Giriş: Bu çalışmada, gastrointestinal stromal tümör (GIST) tanısı almış ve cerrahi tedavi uygulanmış hastalarda, klasik histopatolojik parametrelerin yanı sıra preoperatif dönemde elde edilen sistemik inflamasyon ve beslenme indekslerinin sağkalım ile ilişkisi değerlendirildi.
Gereç ve Yöntem:Retrospektif olarak tasarlanan bu çalışmaya, GIST tanısı ile cerrahi uygulanmış 43 hasta dahil edildi. Hastaların demografik, laboratuvar ve patolojik verileri incelendi. Hematolojik parametrelerden hesaplanan HALP, NLR, SII, PNI ve CRP/Alb gibi indekslerin 3 yıllık sağkalım üzerindeki etkileri Kaplan-Meier yöntemi ve log-rank testi ile değerlendirildi.
Bulgular:Yüksek mitoz sayısı ve Ki67 proliferasyon indeksi, sağkalımı olumsuz etkileyen anlamlı histopatolojik faktörler olarak belirlendi. RDW düzeyi yüksek olan hastalarda sağkalım süresi anlamlı şekilde daha kısaydı (p<0.05). HALP, SII, NLR, PNI ve CRP/Alb oranı gibi kompozit indekslerin cut-off değerlerine göre sınıflandırma doğruluğu orta düzeydeydi.
Sonuç: Bu çalışma, GIST hastalarında yalnızca histopatolojik değil, aynı zamanda sistemik inflamasyon ve beslenme durumunu yansıtan biyobelirteçlerin de sağkalım öngörüsünde kullanılabileceğini ortaya koymuştur. Bu indeksler, postoperatif dönemde bireyselleştirilmiş takip stratejilerine katkı sağlayabilir; ancak bu sonuçların doğrulanması için daha geniş ve prospektif çalışmalara ihtiyaç vardır.

Keywords

GIST , sistemik inflamasyon , sağkalım , HALP , NLR , PNI , SII , CRP/Albumin , RDW

Prognostic Significance of Histopathological and Hematological Markers in Gastrointestinal Stromal Tumors

Abstract

Abstract
Objective: This study aimed to evaluate the relationship between overall survival and preoperative systemic inflammation and nutritional indices in patients with gastrointestinal stromal tumors (GIST), in addition to conventional histopathological parameters.
Methods: In this retrospective study, 43 patients who underwent surgery for GIST were analyzed. Demographic, laboratory, and pathological data were reviewed. Inflammatory and nutritional indices—including HALP, NLR, SII, PNI, and CRP/Albumin—were calculated from preoperative blood parameters. Their effects on 3-year survival were assessed using the Kaplan-Meier method and the log-rank test.
Results: High mitotic count and Ki67 index were significantly associated with decreased survival. Patients with elevated RDW levels had significantly shorter survival times (p<0.05). Classification accuracy for HALP, NLR, SII, PNI, and CRP/Albumin was found to be moderate based on their respective cut-off values.
Conclusion: This study demonstrates that, in addition to histopathological markers, systemic inflammatory and nutritional indices may serve as useful prognostic tools in GIST patients. These indices could aid in the development of individualized follow-up strategies postoperatively. However, further large-scale prospective studies are warranted to validate these findings.

Keywords

GIST , systemic inflammation , survival , HALP , NLR , PNI , SII , CRP/Albumin , RDW

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