Expression of DOG 1 and correlation with Ki-67 and tumor characteristics in GIST: case series analysis in a tertiary care center


  • Danita G. S. Edwin Department of Pathology, Saveetha Medical College, Chennai, Tamil Nadu, India
  • Nithin Diwagar K. Department of Pathology, Saveetha Medical College, Chennai, Tamil Nadu, India
  • Ganthimathy Sekhar Department of Pathology, Saveetha Medical College, Chennai, Tamil Nadu, India



GIST, DOG1, Ki-67


Gastrointestinal stromal tumours (GISTs) are the most common non epithelial, mesenchymal tumours of the gastrointestinal tract and amount to 1 to 3% of all gastrointestinal tumours. Histologically, GISTs demonstrate considerable morphologic variation. The aim of the study was to evaluate the histo-morphological features of GIST and the expression of DOG1 and KI-67 in these tumours. Eleven cases of GISTs received during a five-year period at a tertiary care centre were analysed for their demographic parameters, morphology and risk stratification. Immunohistochemistry for DOG1 and Ki67 was performed for all the eleven cases. In this study there was a female preponderance with the mid -fifties being the median age of presentation. The stomach and small intestine were the common sites of involvement. The histologic type was predominantly spindle cell with a few cases of mixed tumours. DOG 1 was positive in all the tumours and Ki-67 index was markedly elevated in the epithelioid cell type and in the high-risk category of tumours. DOG 1 holds good as an important marker for clinically suspected GIST diagnosis and Ki-67 expression correlates with the risk stratification of the tumour and can be a good prognostic factor.


Sbaraglia M, Businello G, Bellan E, Fassan M, Dei Tos AP. Mesenchymal tumours of the gastrointestinal tract. Pathologica. 2021;113(3):230.

Alshok MM. A clinical study on GIST in Babylon. 2020;1(53):001-5.

ŞAhin S, Ekinci Ö, SEçkin S, DUrSUn A. The diagnostic and prognostic utility of DOG1 expression on gastrointestinal stromal tumors. Turk Patoloji Derg. 2017;33(1):1-8.

Hirota S. Differential diagnosis of gastrointestinal stromal tumor by histopathology and immunohistochemistry. Translational Gastroenterol Hepatol. 2018;3.

Rizzo FM, Palmirotta R, Marzullo A, Resta N, Cives M, Tucci M et al. Parallelism of DOG1 expression with recurrence risk in gastrointestinal stromal tumors bearing KIT or PDGFRA mutations. BMC Cancer. 2016;16:87.

Duvvuri U, Shiwarski DJ, Xiao D, Bertrand C, Huang X, Edinger RS et al. TMEM16A induces APK and contributes directly to tumorigenesis and cancer progression. Cancer Res. 2012;72:3270-81.

Simon S, Grabellus F, Ferrera L, Galietta L, Schwindenhammer B, Mühlenberg T et al. DOG1 regulatesgrowth and IGFBP5 in gastrointestinal stromal tumors. Cancer Res. 2013;73:3661-70.

Mantese, George Gastrointestinal stromal tumor. Curr Opinion Gastroenterol. 2019;35(6):555-9.

Xiao CC, Zhang S, Wang MH, Huang LY, Wu P, Xu Y et al. Clinicopathological features and prognostic factors of rectal gastrointestinal stromal tumors. J Gastrointest Surg. 2013;17:793-8.

Burkill GJ, Badran M, Al-Muderis O, Meirion Thomas J, Judson IR, Fisher C et al. Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread. Radiology. 2003;226:527-32.

Tryggvason G, Kristmundsson T, Orvar K, Jónasson JG, Magnússon MK, Gíslason HG. Clinical study on gastrointestinal stromal tumors (GIST) in iceland, 1990-2003. Dig Dis Sci. 2007;52:2249-53.

Nilsson B, Bümming P, Meis-Kindblom JM, Odén A, Dortok A, Gustavsson B et al. Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era-a population-based study in western Sweden. Cancer. 2005;103:821-9.

King DM. The radiology of gastrointestinal stromal tumours (GIST). Cancer Imaging. 2005;5(1):150.

Lee CH, Liang CW, Espinosa I. The utility of discovered on gastrointestinal stromal tumor 1 (DOG1) antibody in surgical pathology-the GIST of it. Adv Anatomic Pathol. 2010;17(3):222-32.

Lopes LF, West RB, Bacchi LM, van de Rijn M, Bacchi CE. DOG1 for the diagnosis of gastrointestinal stromal tumor (GIST): comparison between 2 different antibodies. Appl Immunohistochem Molecular Morphol. 2010;18(4):333-7.

Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Int J Surgical Pathol. 2002;10(2):81-9.

Artigiani Neto R, Logullo AF, Stávale JN, Lourenço LG. Ki-67 expression score correlates to survival rate in gastrointestinal stromal tumors (GIST). Acta Cir Bras. 2012;27:315-21.

Panizo-Santos A, Sola I, Vega F, de Alava E, Lozano MD, Idoate MA et al. Predicting metastatic risk of gastrointestinal stromal tumors: Role of cell proliferation and cell cycle regulatory proteins. Int J Surg Pathol. 2000;8:133-44.

Noguchi T, Sato T, Takeno S, Uchida Y, Kashima K, Yokoyama S et al. Biological analysis of gastrointestinal stromal tumors. Oncol Rep. 2002;9:1277-82.

Belev B, Brèiæ I, Prejac J, Golubiæ ZA, Vrbanec D, Božikov J et al. Role of Ki-67 as a prognostic factor in gastrointestinal stromal tumors. World J Gastroenterol 2013;19:523-7.

Fletcher CD, Berman JJ, Corless C, Gorstein F. Lasota 9. J, Longley BJ et al. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol. 2002;33(5):459-65.

DeMatteo. Two hundred gastrointestinal stromal tumours; recurrence patterns and prognostic factors for survival, Annals of Surgery. 2000;231(1):51-8

Arber A, Klein E, Bruce S, Sankoh S, Mohideen P. Metformin-glibenclamide versus metformin plus rosiglitazone in patients with type 2 diabetes inadequately controlled on metformin monotherapy. Diabetes Obes Metab. 2006;8(2):156-63.






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