Original Research Article
Year: 2022 | Month: August | Volume: 9 | Issue: 8 | Pages: 678-689
DOI: https://doi.org/10.52403/ijrr.20220856
Study from Tertiary Care Centre Elucidating the Role of CD 117 & DOG 1 Antibodies in Diagnosis of Gastrointestinal Stromal Tumors
Dr Anisha Jaypuriya1, Dr G N Gupta2, Dr Mansi Faujdar3, Dr Shubha Gupta4
1D.N.B Resident, Department of Pathology & Transfusion Medicine, Santokba Durlabhji Hospital, Jaipur
2Senior Consultant & Head, Department of Pathology & Transfusion Medicine, Santokba Durlabhji Hospital, Jaipur
3,4Senior Consultant & Department of Pathology & Transfusion Medicine, Santokba Durlabhji Hospital, Jaipur
Corresponding Author: Dr Anisha Jaypuriya
ABSTRACT
Introduction: Gastrointestinal stromal tumors are the most common mesenchymal tumors in the gastrointestinal tract. The diagnosis of GISTs becomes much more accurate by using IHC (CD117/DOG1) and molecular analysis (KIT/PDGFRA), both of which constitute the gold standard of diagnosis in GISTs.
Aim: The study was conducted in a tertiary care hospital in western India between January, 2019 to June 2020 to evaluate clinic pathological correlation & agreement between CD117 and DOG1 antibodies that are employed in diagnosis of GIST.
Material & Methods: The cases were selected on the basis of inclusion & exclusion criteria defined and thereafter a panel of CD117, DOG1 and other antibodies was applied to diagnose GIST from other mesenchymal tumors of gastrointestinal tract.
Results: The average age of the patient was 53.5 years with male preponderance was noted. (M:F=1.66). The clinical complaints included: GI Bleeding (50%), Abdominal pain (30%), lump abdomen (20%).Most common site for GIST was gastric (50%) followed small intestine (40%), mesentry-omentum (7.50%) and colon (2.50%). Spindle cell morphology (75.00%) was the most common histomorphological subtype. DOG1 antibody diagnosed 97.50 % cases of GIST and CD117 diagnosed 92.50% cases of GIST. DOG1 expressed high staining ratio score in 95% cases while CD117 had high staining ratio score in 87.50% cases. Mostly stronger intensity of immunostaining was observed with DOG1 while CD117 expressed variable intensity of immunostaining. Also, CD117 expressed variable immunostaining amongst different histomorphological variants and risk groups. While immunostaining with DOG1 was not significantly variable. The results demonstrated that DOG-1 was found to be a superior marker with higher sensitivity and specificity as compared to CD117, specificity (100% versus 96.43%) and sensitivity (97.5% versus 92.5%).
Conclusion: The immunohistochemistry panel should be applied in stepwise manner over “morphologically suspicious” cases Mesenchymal Tumours of GIT to diagnose and rule out GIST with first panel being CD117 and DOG1. DOG-1 was found to be a superior marker with higher sensitivity and specificity as compared to CD117. Cases negative for all the antibodies should definitely be referred for molecular analysis to detect other mutations of GIST (kit/PDGFRA negative wild type GIST).
Keywords: GIST, CD 117, DOG 1 antibody
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