MODİFİYE SİSTEMİK İNFLAMASYON SKORU İLE GASTROİNTESTİNAL STROMAL TÜMÖRLERİN PROGNOSTİK GÖSTERGELERİ ARASINDAKİ İLİŞKİ

Abstract

Amaç Gastrointestinal stromal tümörler, gastrointestinal sistem boyunca yerleşebilen mezenkimal kökenli tümörlerdir. Bu çalışmada Modifiye sistemik inflamasyon skorunun (mSIS) bu tümörlerin prognozunu öngörmedeki rolü araştırıldı. Gereç ve Yöntem 1 Haziran 2019 ile 1 Aralık 2022 tarihleri arasında Ankara Şehir Hastanesi'nde ameliyat edilen Gastrointestinal Stromal Tümör (GIST) tanısı alan 115 hasta incelendi. Tümörün lokalizasyonu, boyutu, rüptür-kanama- nekroz varlığı, ki-67 düzeyi, mitotik indeks ve ameliyat öncesi albümin, lenfosit ve monosit düzeyleri değerlendirildi. mSIS skoru 0, 1 ve 2 olarak gruplandırıldı. mSIS ile Ki-67 indeksi, rüptür, nekroz ve kanama varlığı ile ilişkisi araştırıldı. Bulgular 115 hastanın 68'i (% 59) erkek, 47'si (% 41) kadın olup yaş ortalaması 62,5 (± 12,67) idi. Tümör lokasyonları: mide (% 64,3), ince bağırsak (% 26), kolon (% 5,2), yemek borusu (% 1,8), pankreas (% 1,8) ve yumurtalık (% 0,9). 25'inde (% 30,7) nekroz, 67'sinde (% 58,7) kanama, 19'unda (% 16,8) rüptür vardı ve ortalama Ki-67 düzeyi 9,09 (± 10,64) idi. Hastaların 63'ünde (% 54,8) mSIS 0, 29'unda (% 25,2) mSIS 1 ve 23'ünde (% 20) mSIS 2 vardı. İstatistiksel analizlerde, mSIS ile nekroz mevcudiyeti arasında anlamlı bir korelasyon bulundu. Sonuç mSIS skoru vücuttaki inflamasyonu gösteren değerli bir skordur ve birçok malignitenin prognozu ile ilişkili olduğu gösterilmiştir. Çalışmamızda tümörde nekroz varlığı mSIS skoru ile ilişkili bulunmuştur. Bu sonuç tek başına prognozu tahmin etmek için yeterli olmasa da yeni çalışmalara kapı açabilecek bir konu olduğu düşünülmektedir.

Keywords

• Gastrointestinal stromal tümör
• Modifiye sistemik inflamasyon skoru
• Prognoz
• Tümör nekrozu

THE RELATION BETWEEN MODIFIED SYSTEMIC INFLAMMATION SCORE AND PROGNOSTIC MARKERS OF GASTROINTESTINAL STROMAL TUMORS

Abstract

Objective Gastrointestinal stromal tumours are tumours of mesenchymal origin that can be located along the gastrointestinal tract. In this study, the role of Modified systemic inflammation score in predicting the prognosis of these tumours was investigated. Material and Method 115 patients diagnosed with Gastrointestinal Stromal Tumor (GIST) who underwent surgery at Ankara City Hospital between June 1, 2019 and December 1, 2022 were examined. Tumor location, size, presence of rupture-bleeding-necrosis, Ki-67 level, mitotic index and preoperative albumin, lymphocyte and monocyte levels were evaluated. mSIS score was grouped as 0, 1 and 2. The relationship between mSIS and Ki- 67 index and the presence of rupture, necrosis and bleeding was investigated. Results Out of 115 patients, 68 (59 %) were male, 47 (41 %) were female, with an average age of 62.5 (± 12.67) years. Tumor locations: stomach (64.3 %), small intestine (26 %), colon (5.2 %), esophagus (1.8 %), pancreas (1.8 %), and ovary (0.9 %). Necrosis was in 25 (30.7 %), hemorrhage in 67 (58.7 %), rupture in 19 (16.8 %), and the mean Ki-67 level was 9.09 (± 10.64). 63 (54.8 %) patients had mSIS 0, 29 (25.2 %) had mSIS 1, and 23 (20 %) had mSIS 2. Statistical analysis found a significant correlation between mSIS and necrosis, but not with other parameters. Conclusion The mSIS score is a valuable score showing inflammation in the body and has been shown to be associated with the prognosis of many malignancies. In our study, the presence of necrosis in the tumour was found to be associated with the mSIS score. Although this result alone is not sufficient to predict the prognosis, it is thought to be an issue that may open the door to new studies.

Keywords

• Gastrointestinal stromal tumour
• Modified systemic inflammation score
• Prognosis
• Tumour necrosis

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