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

Yıl 2023, Cilt: 30 Sayı: 4, 698 - 702, 30.12.2023

Fırat Canlıkarakaya , Serhat Ocaklı , Cengiz Ceylan , Abidin Göktaş , İlkay Güler , Serdar Gökay Terzioğlu

https://doi.org/10.17343/sdutfd.1382872

Öz

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.

Anahtar Kelimeler

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

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

• 1. Parab TM, DeRogatis MJ, Boaz AM, Grasso SA, Issack PS, Duarte DA, et al. Gastrointestinal stromal tumors: a comprehensive review. Journal of gastrointestinal oncology 2019;10(1):144.
• 2. von Mehren M, Rubin BP, Flieder DB, Raut CP. Gastrointestinal stromal tumors. Textbook of Uncommon Cancer 2017:470-92.
• 3. Ahmed M. Recent advances in the management of gastrointestinal stromal tumor. World journal of clinical cases 2020;8(15):3142.
• 4. Mantese G. Gastrointestinal stromal tumor: epidemiology, diagnosis, and treatment. Current opinion in gastroenterology 2019;35(6):555-9.
• 5. Zhang H, Liu Q. Prognostic indicators for gastrointestinal stromal tumors: a review. Translational Oncology 2020;13(10):100812.
• 6. Yi M, Xia L, Zhou Y, Wu X, Zhuang W, Chen Y, et al. Prognostic value of tumor necrosis in gastrointestinal stromal tumor: A meta-analysis. Medicine 2019;98(17): e15338.
• 7. Climent M, Ryan ÉJ, Stakelum Á, Khaw YL, Creavin B, Lloyd A, et al. Systemic inflammatory response predicts oncological outcomes in patients undergoing elective surgery for mismatch repair-deficient colorectal cancer. International journal of colorectal disease 2019;34:1069-78.
• 8. Suzuki Y, Okabayashi K, Hasegawa H, Tsuruta M, Shigeta K, Kondo T, et al. Comparison of Preoperative Inflammationbased Prognostic Scores in Patients With Colorectal Cancer. Ann Surg. 2018;267(3):527-31.
• 9. Demirelli B, Babacan NA, Ercelep Ö, Öztürk MA, Kaya S, Tanrıkulu E, et al. Modified Glasgow prognostic score, prognostic nutritional index and ECOG performance score predicts survival better than sarcopenia, cachexia and some inflammatory indices in metastatic gastric cancer. Nutrition and cancer 2021;73(2):230-8.
• 10. Tuomisto AE, Mäkinen MJ, Väyrynen JP. Systemic inflammation in colorectal cancer: Underlying factors, effects, and prognostic significance. World journal of gastroenterology 2019;25(31):4383.
• 11. Lin J-X, Lin J-P, Xie J-W, Wang J-b, Lu J, Chen Q-Y, et al. Prognostic importance of the preoperative modified systemic inflammation score for patients with gastric cancer. Gastric Cancer 2019;22:403-12.
• 12. Ataş H, Korukluoğlu B, Çomçali B, Yakşi N, SAYLAM B, Tez M. Can preoperative modified systemic inflammation score (mSIS) be used to predictmalignancy in persistent nondiagnostic thyroid nodules? Turkish Journal of Medical Sciences 2021;51(2):700-5.
• 13. Nishida T, Cho H, Hirota S, Masuzawa T, Chiguchi G, Tsujinaka T. Clinicopathological features and prognosis of primary GISTs with tumor rupture in the real world. Annals of Surgical Oncology 2018;25:1961-9.
• 14. Liu X, Qiu H, Zhang P, Feng X, Chen T, Li Y, et al. Prognostic role of tumor necrosis in patients undergoing curative resection for gastric gastrointestinal stromal tumor: a multicenter analysis of 740 cases in China. Cancer medicine 2017;6(12):2796-803.
• 15. Liu Q, Li Y, Dong M, Kong F, Dong Q. Gastrointestinal bleeding is an independent risk factor for poor prognosis in GIST patients. BioMed research international 2017:2017:7152406. doi: 10.1155/2017/7152406.
• 16. Lv A, Li Z, Tian X, Guan X, Zhao M, Dong B, Hao C. SKP2 high expression, KIT exon 11 deletions, and gastrointestinal bleeding as predictors of poor prognosis in primary gastrointestinal stromal tumors. PloS one 2013;8(5):e62951. https://doi.org/10.1371/journal.pone.006295