Présentations cliniques et pronostiques des tumeurs stromales gastro-intestinales (GIST) dans un service d’oncologie médicale d’Afrique subsaharienne, à l’ère des thérapies ... View Full Text


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Article Info

DATE

2017-09

AUTHORS

D. A. Diallo, A. K. Dembélé, E. Auberger, M. Ly, B. A. Touré, A. Guindo, M. Bathily, C. O. Samaké, M. B. Sidibé, Y. Badiaga, G. Diallo, K. Dumke

ABSTRACT

Les tumeurs stromales gastro-intestinales (GIST, gastro-intestinal stromal tumor) sont des tumeurs rares dont l’individualisation a été possible grâce aux techniques d’immunomarquage, et dont le pronostic a été considérablement amélioré grâce aux antityrosines-kinases. Leurs caractéristiques sont peu étudiées en Afrique subsaharienne. Notre étude décrit les caractéristiques cliniques et pronostiques de 15 cas de GIST dans un service d’oncologie médicale subsaharien à l’ère des antityrosines-kinases. Ces cas représentaient 4,3 % des tumeurs digestives et affectaient 11 hommes et quatre femmes, dont l’âge moyen était de 62 ± 9,9 ans. Leurs circonstances de diagnostic étaient dominées par la douleur épigastrique (67 %) et le syndrome occlusif (13 %), reflétant leurs localisations surtout gastriques (53 %) et grêliques (20 %). Les types histologiques fréquents étaient la forme fusiforme (80 %) et la forme épithélioïde (13 %). Toutes les tumeurs exprimaient le CD117 et avaient un index mitotique supérieur à 5/50 CFG (Champs à Fort Grossissement), trois exprimaient en plus le DOG1. La tumeur était métastatique et non opérable chez sept patients, opérée chez les huit autres. Un traitement par imatinib mésylate a permis d’obtenir une rémission complète chez les huit patients opérés, une stabilisation des lésions chez deux patients non opérés avec un recul de suivi de 2 à 96 mois. Cinq cas métastatiques avaient progressé avec une issue fatale pour quatre patients. En conclusion, les GIST ont, dans notre contexte, des localisations le plus souvent gastriques ou grêliques, sans spécificité clinique. Leur sensibilité à l’imatinib mésylate incite à les évoquer devant toute symptomatologie digestive chez le sujet âgé de plus de 40 ans. More... »

PAGES

111-115

Journal

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12157-017-0711-y

DOI

http://dx.doi.org/10.1007/s12157-017-0711-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1084034262


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