The Diagnostic and Prognostic Utility of DOG1 Expression on Gastrointestinal Stromal Tumors

Sevinç ŞAHİN; Özgür EKİNCİ; Selda SEÇKİN; Ayşe DURSUN

doi:10.5146/tjpath.2016.01376

Objective: We aimed to review our archives in order to evaluate both the diagnostic and prognostic significance of DOG1 on gastrointestinal stromal tumors (GISTs), and add further insight about those issues to the current literature including some conflicting results.

Material and Method: DOG1 was evaluated in 100 cases of GISTs, immunohistochemically. Immunostaining index was counted for each antibody by using both the intensity and extent of staining. The association between immunostaining index of DOG1 and CD117, CD34, SMA desmin, S-100, and Ki-67 index and clinicopathological features were analyzed.

Results: Ninety cases were positive for DOG1, and 89 were positive for CD117. All CD117-negative tumors were positive for DOG1. High-risk group was directly correlated with tumor diameter, cellularity, necrosis, nuclear pleomorphism, mitotic count and Ki-67 index, by univariate analysis. The association between high-risk group and tumor diameter, mitotic count, and Ki-67 index was proved by multivariate analysis. Immunostaining index of DOG1, Ki-67 index, mitotic count, ulceration and hemorrhage were inversely correlated with overall survival by univariate analysis. The adverse impact of DOG1 ISI and mitotic count on overall survival were supported by multivariate analysis.

Conclusion: DOG1 positivity was detected in most of GISTs and all in CD117-negative cases as a result underlining its diagnostic utility. Additionally, DOG1 overexpression was related with adverse prognosis. Thus, we suggest that immunostaining index of DOG1 should routinely be used while diagnosing GIST, and DOG1 might be considered as a potential prognostic tool and a target for novel therapies.