Tumores estromales gastrointestinales: Evolución conceptual.
DOI:
https://doi.org/10.31053/1853.0605.v61.n1.26873Palabras clave:
tumor estromal gastrointestinal, leiomioblastorna, tumor autonómico gastrointestinal, células intersticiales de Cajal, fibras eskenoides, c-kit (CDII 7), CD34Resumen
Los tumores estrornales gastrointestinales (GastroIntestinal Stromal Tuniors - GISTs—) constituyen la categoría más amplia de neoplasias no epiteliales primarias del tracto gastrointestinal y representan aproximadamente el 1-2% de todas las neoplasias del tubo digestivo. Ocurren más frecuentemente en estómago y en intestino delgado, pero también pueden estar presentes en otros sitios del tracto gastrointestinal tubular, incluyendo esófago, colon, recto y ano. Además, han sido encontrados en sitios tales como retroperi tonco. útero, omento, mesocolon y tejidos blandos. Originalmente reconocidos en 1960 por Martin como una entidad clínicopatológica y un tipo distintivo de neoplasia estromal gástrica, los GISTs fueron posteriormente publicados por Stout. quien introdujo el término leiomioblastoma. Debido a la dificultad en predecir con seguridad el comportamiento biológico de estos tumores, el término «tumor de músculo liso de potencial maligno incierto» fue introducido para los tumores borderline. En 1983. Mazur y Clark acuñaron el término "tumor estromal gastrointestinal" y sugirieron que estas lesiones podían originarse del sistema nervioso mientérico. Algunos estudios reportaron evidencias de una diferenciación neural en algunos GISTs y fué introducido el término «tumor autonómico gastrointestinal (GANT). En 1998, Kindbiom y col., establecieron un nuevo candidato en la línea de diferenciación de los GISTs y sugirieron que estas neoplasias muestran una diferenciación inmunofenotípica hacia células intersticiales (le Cajal (células marcapasos del tracto gastrointestinal). Inmunohistoquímicamente los GISTs revelan frecuentemente inmunoreactividad para virnentina (VIM), CD34 y c-kit (CD1 17). El objetivo del presente trabajo es realizar un análisis de la evolución histórica y conceptual de los GISTs.
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Moral Moral G. Gil Piedra E Velasco Osés A y col.: Tumores estromales del tubo digestivo. Valor pronóstico del índice mitótico. Rey Esp Enferm Dig; 1998,90(5): 335-339
Miettinen M. Sarlomo-Rikala M. Lasota J: Gastrointestinal stromal tumours. [Review] 127 refsl. Annales Chirurgiae et Gynaecologiae; 1998,87(4): 278-281
Martin JE Bazin P Feroldi ,J, Cabanne F: Tumeurs rnyoides intra-murales des 1 estomac. Considcrations niicroscopiques a propos de 6 caS. AnnAnatPathol (París): 1960,13:25-33
Stout AP Bizarre smooth muscle tumours of the stomach. Cancer; 1962.15:400-409
Enzinger F.M., Lattcs. R. and Tortoloni. H. Histological Trping of Soft Tissue Tumours. International i-listological Classification of Tumours N 3. Geneva. 1969, World Health Organization
Morson BC. Dawson IMP: Gastrointestinal Pathology. Edited by Blackwell scie.ntific puhlications, Oxford, London, Edinburgh, Melbourne. 1974, p 368 -371. 2a. Ed. S.
Hendrickson R, Kempson RL: Smooth muscle tumours. In: Whitehead R. ed. Gastrointestinal and üesophageal Pathology. ¡st ed. Edinburgh:Churchill Livingstone. 1989. 619 -628
Chan JKC.: Mesenchymal Tumors of the Gastrointestinal Tract : A Paradise for Acronisms (STUMR GIST, GANT aral Now GIPACT), Implication of c-kit in Genesis, and yet Another of the Many Emerging Roles of the lnterstitial Celi of Cajal in the Pathogenesis of Gastrointestinal 1)iseases?. Advances ¡u Anatomic Pathology; 1999, 6(1): 19-40
Mazur MT, Clark HB: Gastric stromal tumors reappraisal of histogenesis. AmJSurg Pathol: 1983. 7: 507-519
Walker P. Dvorak AM: Gastrointestinal autonomic nerve (OAN) tumor. Ultrastructural evidence for a newly recognized entity. Arch Pathol Lab Med: 1986, 110: 309- 316
Herrera GA, Ccrezzo L, Janes JE. Sack J, et al: Gastrointestinal autonomic nerve tumors. "Plexosarcomas" Arch Pa thai LahMed: 1989.113:846-853
Kindhlom LO, Meis-Kindblom JM. Remotti HE, Aldenborg F: Gastrointestinal pacemaker: GJPACT: gastrointestinal stromal tumors show phenotypic characteristies of the interstitial celis of Cajal. Am J Pathol; 1998.152:1259-1269
Cajal S: Sur les ganglions et plexus nerveux de 1 intestin. Compt Renci Soc Biol. París; 1893, 45:217-223
ThunebergL: Intersiltial cells of Cajal: intestinal pacemaker cells?. Advances in Anatomy, Embriology and Celi Biology. Edited by F Beck. W Flild, J van Limborgh,R. Ortmann, JE Pauly, TH Sehiebler. Berlin. Heidelberg, New York. 1982.p 1-130. Springer Verlag.
ThomscnTL, Robinson TL. Lee JCF, et al: Interstitial celis of Cajal generate a rhvthrnic pacemaker current. Nature Med: 1998,4:848-851
MietUnem M. Furiong M. SarlomoRikala M y col: Gastrointestinal stromal tumors intramural leiomyomas and lciomyosarconias in the rectum and anus. A c1inicopathohlc, inmunohistochcmical. and molecular genetie study of 144 cases. Am 3 Surg Pathol; 2001, 25(9): 1121- 1133
Lavin P Hadju SI, Feote FW: Gastric and extragastrie leiomyoblastomas. Clinicopathologic study of 44 cases. Cancer: 1972.29:305 -3 11
Miettincn M. Lasota J: Gastrointestinal stromal tumors-definitlon. clinical, histological, immunohistochemical. and molecular genetic features and differential diagnosis. Virchows Arch; 2001, 438:1-12
Ortega Medina L. Saiz-Pardo Sanz, M: Tumores del estroma gastrointestinal: Cambio conceptual de los tumores estromales gastrointestinales (GISTs) y criterios de malignidad. Oncolog (Barc); 2004, 27(4): 1-7
Flctcher CD, Berman JJ. Corlcss C, Gorstein E Sobin LFI y col: Diagnosis of gastrointestinal stromal tumors: A consensus approach. HumPathol: 2002, 33:459-465
Sircar K. Hewlet BR, Huizinga JD, Chorneyko y col: lnterslitial cclls of Cala-]- as precursors of gastrointestinal stromal tumors. Am J Surg Pathol; 1999, 23 (4): 377 - 389
Erlandson RA, Klimstra DS, Wooddruff JM: Subclassification of gastrointestinal stromal tumors based mi evaluation by electron microscopy and inmunohistochemistry Ultrastr Pathol: 1996, 20: 373-393
Hirota S. Isozaki K. Moriyama Y et al: Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science: 1998, 279: 577-580
Farrugia G, Kim CH, Grant CS, Zinsmeister AR: Leiomyosarcoma of the stomach. Determinants of long-term survival. Mayo Clin Proc: 1992,67: 533-536
Persson S, Kindblom LG, Angervali L. Tiscli LE: Metastasizinggastric epithelioid leioinyosarcomas (leionwoblastomas) in young individuals with long-term survival. Cancer; 1992.70:721-732
Fuller CE, Williams GT: Gastrointestinal manifestations of type 1 neurofibromatosis (von Recklinghausen 's disease). Histopathology: 1991, 19: 1-11
Carney JA, Sep SG, Go VI- Gordon 11: 'l'he triad of gastric leiomyosarcorna, functioning extra-adrenal paragariglioma and pulmonary chondrorna. NEng1JMed; 1977,296: 1517-1518
Miettinem M. Virolainen M, SarlomoRikala M: Gastrointestinal stromal tuniorsvalue of CD34 antigen in their identification and separation from true leiomyomas and schwannomas. Am J SurgPathol: 1995.19: 207-216
Clary BM. DeMatteo RP Lewis JJ y col: Gastrointestinal stromal tumors and leiornyosarcoma of the abdomen and retroperitoneum: a clinical comparison. Am Surg Oncol: 2001, 8(4): 290-299
Pauwels 11 Debiec-Rychter M. Stul M y col.: Chariging phenotype of gastrointestinal stromal tumours under Imatinib rnesylatc treatrnent: a potential cliagnostic pitfall. I-listopathologv; 2005,47:41-47
Miettinem M. El-Rifai W. H L Sobin L. Lasota J: Evaluation of malignancy and prognosis of gastrointestinal stromal tumors: a review. Ilum Pathol; 2002,33:478-483
Emory TS, Sohin L, Lukes L. Lee DII, O'Leary TJ: Prognosis of gastrointestinal smooth-rnuscle (stromal) tumors. Depenclence on anatomic site. Am J Surg Pathol; 1999, 23(1): 82-87
Evans HL: Smooth muscle neoplasm of the gastrointestinal tract: a study of 56 cases followcd for a minimum of ten years. Cancer: 1985, 56: 2242-2250
Amin MB, Ma CK, Linden MD y col: Pronostic value of proiiferating ceil nuclear antigen index in gastric stromal tumors: correlation with mitotic count and clinical outcome. Am J Clin Pathol: 1993, 100: 428- 432
Tworek JA, Appelman HD, Singleton TP Greenson JK: Stromal tumors of the jcjunum and ileum. Mod Pathol; 1997, 10: 200-209
El-Rifa¡ W. Sarlomo-Rikala M, Andcrsson LC y col. DNA sequence copy number changes in gastrointestinal stromal tumors: tumor progression and prognostic significance. Cáncer Res; 2000, 60: 3899- 3903
Kim NG, Kim JJ, Ahn JY. Seong CM y col: Putative chromosomal deletions on 9R 9Q and 22Q occur preferentially in malignant gastrointestinal stromal tumors. mt j Cancer: 2000, 85: 633-638
Gunther T, Schrieider-Stock R, Hackel C y col: Telomerase activity and expression of hTRT and hTR in gastrointestinal stromal tumors in comparison with extragastrointestinal sarcomas. Clin Cancer Res; 2000, 6: 1811- 1818
Pauls K. Merkelbach-Bruse S. Thai D y col: PDGFR á - and c-kit-mutated gastrointestinal stromal turnours (GISTs) are characterized by distinctive histological and inmunohistochemical features. Histopahoiogy: 2005,46: 166-175.
Yantiss R, Sl)iro 1, Compton C y col: Gastrointestinal stromal tumor versus intraabdominal fibromatosis of the bowel wall. Am J Surg Pathol: 2000,24(7): 947-957
Huizinga JD. Thuneberg L. Kluppel y col.: W/kit gene required for interstitial cells of Cajal and for intestinal pacemaker activity. Nature: 1995,373: 347-349
Miettinen M, Sarlomo-Rikala M. Lasota J: Gastrointestinal Stromal Tumors: recent advanees in understanding of their biology. HumPathol; 1999,30: 1213-1220
Saul SH, Rast MI. Brooks JJ: The inmunohistochemistry of gastrointestinal stromal tumors. Evidence supportingorigin from smooth muscle. Am J Surg Pathol: 1987,11:464-473
Weiss RA, Mackay B: Maiignant smooth muscle tumors of the gastrointestinal tract: an ultrastructural study of 20 cases. Ultrastruct Pathol: 1981. 2: 231-240
Miettinen M. Sohin LH, Lasota J. Gastrointestinal stromal tumors of the stomach: a clinicopathologie, inmunohistochemical, and molecular genelic study of 1765 cases with long-term followup. Am J Surg Pathol; 2005, 29: 52-68.
Moral Moral G. Gil Piedra E Velasco Osés A y col.: Tumores estromales del tubo digestivo. Valor pronóstico del índice mitótico. Rey Esp Enferm Dig; 1998,90(5): 335-339
Miettinen M. Sarlomo-Rikala M. Lasota J: Gastrointestinal stromal tumours. [Review] 127 refsl. Annales Chirurgiae et Gynaecologiae; 1998,87(4): 278-281
Martin JE Bazin P Feroldi ,J, Cabanne F: Tumeurs rnyoides intra-murales des 1 estomac. Considcrations niicroscopiques a propos de 6 caS. AnnAnatPathol (París): 1960,13:25-33
Stout AP Bizarre smooth muscle tumours of the stomach. Cancer; 1962.15:400-409
Enzinger F.M., Lattcs. R. and Tortoloni. H. Histological Trping of Soft Tissue Tumours. International i-listological Classification of Tumours N 3. Geneva. 1969, World Health Organization
Morson BC. Dawson IMP: Gastrointestinal Pathology. Edited by Blackwell scie.ntific puhlications, Oxford, London, Edinburgh, Melbourne. 1974, p 368 -371. 2a. Ed. S.
Hendrickson R, Kempson RL: Smooth muscle tumours. In: Whitehead R. ed. Gastrointestinal and üesophageal Pathology. ¡st ed. Edinburgh:Churchill Livingstone. 1989. 619 -628
Chan JKC.: Mesenchymal Tumors of the Gastrointestinal Tract : A Paradise for Acronisms (STUMR GIST, GANT aral Now GIPACT), Implication of c-kit in Genesis, and yet Another of the Many Emerging Roles of the lnterstitial Celi of Cajal in the Pathogenesis of Gastrointestinal 1)iseases?. Advances ¡u Anatomic Pathology; 1999, 6(1): 19-40
Mazur MT, Clark HB: Gastric stromal tumors reappraisal of histogenesis. AmJSurg Pathol: 1983. 7: 507-519
Walker P. Dvorak AM: Gastrointestinal autonomic nerve (OAN) tumor. Ultrastructural evidence for a newly recognized entity. Arch Pathol Lab Med: 1986, 110: 309- 316
Herrera GA, Ccrezzo L, Janes JE. Sack J, et al: Gastrointestinal autonomic nerve tumors. "Plexosarcomas" Arch Pa thai LahMed: 1989.113:846-853
Kindhlom LO, Meis-Kindblom JM. Remotti HE, Aldenborg F: Gastrointestinal pacemaker: GJPACT: gastrointestinal stromal tumors show phenotypic characteristies of the interstitial celis of Cajal. Am J Pathol; 1998.152:1259-1269
Cajal S: Sur les ganglions et plexus nerveux de 1 intestin. Compt Renci Soc Biol. París; 1893, 45:217-223
ThunebergL: Intersiltial cells of Cajal: intestinal pacemaker cells?. Advances in Anatomy, Embriology and Celi Biology. Edited by F Beck. W Flild, J van Limborgh,R. Ortmann, JE Pauly, TH Sehiebler. Berlin. Heidelberg, New York. 1982.p 1-130. Springer Verlag.
ThomscnTL, Robinson TL. Lee JCF, et al: Interstitial celis of Cajal generate a rhvthrnic pacemaker current. Nature Med: 1998,4:848-851
MietUnem M. Furiong M. SarlomoRikala M y col: Gastrointestinal stromal tumors intramural leiomyomas and lciomyosarconias in the rectum and anus. A c1inicopathohlc, inmunohistochcmical. and molecular genetie study of 144 cases. Am 3 Surg Pathol; 2001, 25(9): 1121- 1133
Lavin P Hadju SI, Feote FW: Gastric and extragastrie leiomyoblastomas. Clinicopathologic study of 44 cases. Cancer: 1972.29:305 -3 11
Miettincn M. Lasota J: Gastrointestinal stromal tumors-definitlon. clinical, histological, immunohistochemical. and molecular genetic features and differential diagnosis. Virchows Arch; 2001, 438:1-12
Ortega Medina L. Saiz-Pardo Sanz, M: Tumores del estroma gastrointestinal: Cambio conceptual de los tumores estromales gastrointestinales (GISTs) y criterios de malignidad. Oncolog (Barc); 2004, 27(4): 1-7
Flctcher CD, Berman JJ. Corlcss C, Gorstein E Sobin LFI y col: Diagnosis of gastrointestinal stromal tumors: A consensus approach. HumPathol: 2002, 33:459-465
Sircar K. Hewlet BR, Huizinga JD, Chorneyko y col: lnterslitial cclls of Cala-]- as precursors of gastrointestinal stromal tumors. Am J Surg Pathol; 1999, 23 (4): 377 - 389
Erlandson RA, Klimstra DS, Wooddruff JM: Subclassification of gastrointestinal stromal tumors based mi evaluation by electron microscopy and inmunohistochemistry Ultrastr Pathol: 1996, 20: 373-393
Hirota S. Isozaki K. Moriyama Y et al: Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science: 1998, 279: 577-580
Farrugia G, Kim CH, Grant CS, Zinsmeister AR: Leiomyosarcoma of the stomach. Determinants of long-term survival. Mayo Clin Proc: 1992,67: 533-536
Persson S, Kindblom LG, Angervali L. Tiscli LE: Metastasizinggastric epithelioid leioinyosarcomas (leionwoblastomas) in young individuals with long-term survival. Cancer; 1992.70:721-732
Fuller CE, Williams GT: Gastrointestinal manifestations of type 1 neurofibromatosis (von Recklinghausen 's disease). Histopathology: 1991, 19: 1-11
Carney JA, Sep SG, Go VI- Gordon 11: 'l'he triad of gastric leiomyosarcorna, functioning extra-adrenal paragariglioma and pulmonary chondrorna. NEng1JMed; 1977,296: 1517-1518
Miettinem M. Virolainen M, SarlomoRikala M: Gastrointestinal stromal tuniorsvalue of CD34 antigen in their identification and separation from true leiomyomas and schwannomas. Am J SurgPathol: 1995.19: 207-216
Clary BM. DeMatteo RP Lewis JJ y col: Gastrointestinal stromal tumors and leiornyosarcoma of the abdomen and retroperitoneum: a clinical comparison. Am Surg Oncol: 2001, 8(4): 290-299
Pauwels 11 Debiec-Rychter M. Stul M y col.: Chariging phenotype of gastrointestinal stromal tumours under Imatinib rnesylatc treatrnent: a potential cliagnostic pitfall. I-listopathologv; 2005,47:41-47
Miettinem M. El-Rifai W. H L Sobin L. Lasota J: Evaluation of malignancy and prognosis of gastrointestinal stromal tumors: a review. Ilum Pathol; 2002,33:478-483
Emory TS, Sohin L, Lukes L. Lee DII, O'Leary TJ: Prognosis of gastrointestinal smooth-rnuscle (stromal) tumors. Depenclence on anatomic site. Am J Surg Pathol; 1999, 23(1): 82-87
Evans HL: Smooth muscle neoplasm of the gastrointestinal tract: a study of 56 cases followcd for a minimum of ten years. Cancer: 1985, 56: 2242-2250
Amin MB, Ma CK, Linden MD y col: Pronostic value of proiiferating ceil nuclear antigen index in gastric stromal tumors: correlation with mitotic count and clinical outcome. Am J Clin Pathol: 1993, 100: 428- 432
Tworek JA, Appelman HD, Singleton TP Greenson JK: Stromal tumors of the jcjunum and ileum. Mod Pathol; 1997, 10: 200-209
El-Rifa¡ W. Sarlomo-Rikala M, Andcrsson LC y col. DNA sequence copy number changes in gastrointestinal stromal tumors: tumor progression and prognostic significance. Cáncer Res; 2000, 60: 3899- 3903
Kim NG, Kim JJ, Ahn JY. Seong CM y col: Putative chromosomal deletions on 9R 9Q and 22Q occur preferentially in malignant gastrointestinal stromal tumors. mt j Cancer: 2000, 85: 633-638
Gunther T, Schrieider-Stock R, Hackel C y col: Telomerase activity and expression of hTRT and hTR in gastrointestinal stromal tumors in comparison with extragastrointestinal sarcomas. Clin Cancer Res; 2000, 6: 1811- 1818
Pauls K. Merkelbach-Bruse S. Thai D y col: PDGFR á - and c-kit-mutated gastrointestinal stromal turnours (GISTs) are characterized by distinctive histological and inmunohistochemical features. Histopahoiogy: 2005,46: 166-175.
Yantiss R, Sl)iro 1, Compton C y col: Gastrointestinal stromal tumor versus intraabdominal fibromatosis of the bowel wall. Am J Surg Pathol: 2000,24(7): 947-957
Huizinga JD. Thuneberg L. Kluppel y col.: W/kit gene required for interstitial cells of Cajal and for intestinal pacemaker activity. Nature: 1995,373: 347-349
Miettinen M, Sarlomo-Rikala M. Lasota J: Gastrointestinal Stromal Tumors: recent advanees in understanding of their biology. HumPathol; 1999,30: 1213-1220
Saul SH, Rast MI. Brooks JJ: The inmunohistochemistry of gastrointestinal stromal tumors. Evidence supportingorigin from smooth muscle. Am J Surg Pathol: 1987,11:464-473
Weiss RA, Mackay B: Maiignant smooth muscle tumors of the gastrointestinal tract: an ultrastructural study of 20 cases. Ultrastruct Pathol: 1981. 2: 231-240
Miettinen M. Sohin LH, Lasota J. Gastrointestinal stromal tumors of the stomach: a clinicopathologie, inmunohistochemical, and molecular genelic study of 1765 cases with long-term followup. Am J Surg Pathol; 2005, 29: 52-68.
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2004-03-09
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1.
Fonseca IB, Spitale LS, Gramática L, Cejas H, Piccinni DJ, Ghirardi G. Tumores estromales gastrointestinales: Evolución conceptual. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 9 de marzo de 2004 [citado 27 de abril de 2024];61(1):20-6. Disponible en: https://revistas.unc.edu.ar/index.php/med/article/view/26873
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