Utility of DOG1 Immunomarker in Fine Needle Aspirates of Gastrointestinal Stromal Tumor

Needle tract seeding and abdominal recurrence following pre-treatment biopsy of gastrointestinal stromal tumors (GIST): results of a systematic review

BACKGROUND

Gastrointestinal stromal tumors (GIST) are rare abdominal tumors. Pretreatment biopsies may be used to diagnose a GIST and enable tailored treatment. Some experts are skeptical about biopsies because they fear tumor cell seeding. The objective of this study was to determine if pretreatment biopsy is associated with increased tumor recurrence.

METHODS

We performed a systematic literature search and included studies assessing the oncological outcome of GIST patients who underwent a pre-treatment core needle biopsy or fine needle aspiration. We assessed methodological quality with the Newcastle-Ottawa-Scale for non-randomized studies. This review was registered in the PROSPERO database (CRD42021170290).

RESULTS

Three non-randomized studies and eight case reports comprising 350 patients were eligible for inclusion. No prospective study designed to answer the review question was found. One case of needle tract seeding after percutaneous core needle biopsy of GIST was reported. None of the studies reported an increased rate of abdominal recurrence in patients with pretreatment biopsy.

CONCLUSIONS

The existing evidence does not indicate a relevant risk of needle tract seeding or abdominal recurrence after pre-treatment biopsy of GIST. Biopsy can safely be done to differentiate GIST from other tumors and to select the most appropriate treatment.

[Diltiazem inhibits proliferation and motility of hepatocellular cells in vitro by downregulating calcium-activated chloride channel TMEM16A]

OBJECTIVE

To assess the inhibitory effect of diltiazem, a calcium channel inhibitor, on the proliferation and mobility of human hepatocellular carcinoma cells in vitro and explore the possible mechanism.

METHODS

Two human hepatocellular carcinoma cell lines, MHCC97H and 7402, were treated with different concentrations (0-400 μmol/L) of diltiazem for 12, 24, or 48 h, and the changes in the cell proliferation and mobility were observed with MTT assay and wound healing assay, respectively. The changes in the expressions of calcium-activated chloride channel TMEM16A at mRNA and protein levels in the treated cells were detected using RT-PCR and immunocytochemistry.

RESULTS

Treatment with diltiazem obviously inhibited the proliferation and suppressed the mobility of MHCC97H and 7402 cells in a time- and concentration-dependent manner (P < 0.05). Treatment with 100 μmol/L diltiazem for 24 h significantly inhibited the proliferation of MHCC97H cells and down-regulated the mRNA and protein levels of TMEM16A. In 7402 cells, diltiazem treatment at 50 μmol/L for 48 h resulted in the most significant inhibitory effect on the cell proliferation and TMEM16A expressions.

CONCLUSIONS

Diltiazem can transiently inhibit the invasion of hepatocellular carcinoma cells in vitro possibly by down-regulating the expression of TMEM16A at both the mRNA and protein levels.

A case of successful detection of disseminated gastrointestinal stromal tumors by ascites smear cytology using cell block preparation with DOG1 immunostaining

Cytological features of gastrointestinal stromal tumors (GISTs) have been reported, especially regarding fine-needle aspiration cytology, including immunostaining for c-kit and DOG1. Meanwhile, cytological findings of GISTs on ascites cytology have rarely been reported, which may be owing to the rare appearance of GIST tumor cells in ascites. Herein, we present a 66-year-old woman who had disseminated GISTs in the abdomen. The GIST tumor cells appeared sparsely in the ascites smear cytology using ascites obtained at the time of autopsy. Even when widespread intra-abdominal dissemination takes place, GISTs may be hard to detect in ascites smear cytology, based on the experience of this case. However, immunohistochemistry of DOG1 using a cell block preparation was found to clearly visualize the GIST tumor cells, although they were sparsely present. Immunostaining of c-kit did not provide as clear an identification of the tumor cells as DOG1 did. When suspicious about GISTs, it is wise to prepare a cell block to make it possible to visualize the tumor cells immunohistochemically.