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Erschienen in: Indian Journal of Gastroenterology 6/2010

01.11.2010

Gastrointestinal stromal tumors: a clinicopathological and immunohistochemical study of 121 cases

verfasst von: Mukul Vij, Vinita Agrawal, Ashok Kumar, Rakesh Pandey

Erschienen in: Indian Journal of Gastroenterology | Ausgabe 6/2010

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Abstract

Background

Primary mesenchymal tumors of the gastrointestinal tract are a heterogeneous group of tumors with a wide clinical spectrum, of which gastrointestinal stromal tumors (GIST) typically occur in middle-aged to older individuals. This study evaluated the clinicopathological and morphological features of GIST of the intestinal tract.

Methods

The study included 108 gastrointestinal and 13 extra-gastrointestinal stromal tumors involving the mesentry and retroperitoneum between January 1989 and July 2007. Immunohistochemical expression of CD117, CD34, SMA, Desmin, S100, and Ki-67 were studied.

Results

GIST comprised 108 of 120 (90%) of the mesenchymal tumors. The tumor was located in the stomach in the majority (55%) of patients followed by small intestine (30%), retroperitoneum (7%) and the colorectum (4%). There was a significant correlation between tumor size and mitotic index, with larger tumors having higher mitotic index (p < 0.001). Mitotic index per 5 mm2 correlated with high cellularity (p < 0.001), presence of necrosis (p < 0.001) and presence of mucosal invasion (p = 0.01). Expression of CD117 was seen in 94%, CD34 in 59%, SMA in 41%, S-100 in 33%, and desmin in 4% of tumors.

Conclusion

We found GIST to be the most common mesenchymal tumor of the gastrointestinal tract.
Literatur
1.
Zurück zum Zitat Mazur MT, Clark HB. Gastric stromal tumors. Reappraisal of histogenesis. Am J Surg Pathol. 1983;7:507–19.CrossRefPubMed Mazur MT, Clark HB. Gastric stromal tumors. Reappraisal of histogenesis. Am J Surg Pathol. 1983;7:507–19.CrossRefPubMed
2.
Zurück zum Zitat Miettinen M, Virolainen M, Sarlomo-Rikala M. Gastrointestinal stromal tumors—value of CD34 antigen in their identification and separation from true leiomyomas and schwannomas. Am J Surg Pathol. 1995;19:207–16.CrossRefPubMed Miettinen M, Virolainen M, Sarlomo-Rikala M. Gastrointestinal stromal tumors—value of CD34 antigen in their identification and separation from true leiomyomas and schwannomas. Am J Surg Pathol. 1995;19:207–16.CrossRefPubMed
3.
Zurück zum Zitat Hirota S, Isozaki K, Moriyama Y, et al. Gain of function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279:577–80.CrossRefPubMed Hirota S, Isozaki K, Moriyama Y, et al. Gain of function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279:577–80.CrossRefPubMed
4.
Zurück zum Zitat Sarlomo-Rikala M, Kovatich AJ, Barusevicius A, et al. CD117: a sensitive marker for gastrointestinal stromal tumors that is more specific than CD34. Mod Pathol. 1998;11:728–34.PubMed Sarlomo-Rikala M, Kovatich AJ, Barusevicius A, et al. CD117: a sensitive marker for gastrointestinal stromal tumors that is more specific than CD34. Mod Pathol. 1998;11:728–34.PubMed
5.
Zurück zum Zitat Lamba M, Mukherjee G, Saini K, et al. Clinico-pathologic pattern of gastrointestinal stromal tumours (GIST) in southern India: A single-institution experience (abstract). J Clin Oncol. 2007;25(18S):20531. Lamba M, Mukherjee G, Saini K, et al. Clinico-pathologic pattern of gastrointestinal stromal tumours (GIST) in southern India: A single-institution experience (abstract). J Clin Oncol. 2007;25(18S):20531.
6.
Zurück zum Zitat Nada R, Vaiphei K, Singh R, et al. Gastrointestinal stromal tumours the assessment of malignant potential. Indian J Pathol Microbiol. 2001;44:393–7.PubMed Nada R, Vaiphei K, Singh R, et al. Gastrointestinal stromal tumours the assessment of malignant potential. Indian J Pathol Microbiol. 2001;44:393–7.PubMed
7.
Zurück zum Zitat Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70–83.CrossRefPubMed Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70–83.CrossRefPubMed
8.
Zurück zum Zitat Agaimy A, Wunsch PH. Gastrointestinal stromal tumours: a regular origin in the muscularis propria, but an extremely diverse gross presentation. A review of 200 cases to critically re-evaluate the concept of so-called extra-gastrointestinal stromal tumours. Langenbecks Arch Surg. 2006;39:322–9.CrossRef Agaimy A, Wunsch PH. Gastrointestinal stromal tumours: a regular origin in the muscularis propria, but an extremely diverse gross presentation. A review of 200 cases to critically re-evaluate the concept of so-called extra-gastrointestinal stromal tumours. Langenbecks Arch Surg. 2006;39:322–9.CrossRef
9.
Zurück zum Zitat Reith JD, Goldblum GR, Lyles RH, et al. Extragastrointestinal (soft tissue) stromal tumors: an analysis of 48 cases with emphasis on histologic predictors of outcome. Mod Pathol. 2000;13:577–85.CrossRefPubMed Reith JD, Goldblum GR, Lyles RH, et al. Extragastrointestinal (soft tissue) stromal tumors: an analysis of 48 cases with emphasis on histologic predictors of outcome. Mod Pathol. 2000;13:577–85.CrossRefPubMed
10.
Zurück zum Zitat Miettinen M, Monihan JM, Sarlomo-Rikala M, et al. Primary in the omentum and mesentery: Clinicopathologic and immunohistochemical study of 26 cases. Am J Surg Pathol. 1999;23:1109–18.CrossRefPubMed Miettinen M, Monihan JM, Sarlomo-Rikala M, et al. Primary in the omentum and mesentery: Clinicopathologic and immunohistochemical study of 26 cases. Am J Surg Pathol. 1999;23:1109–18.CrossRefPubMed
11.
Zurück zum Zitat Steigen SE, Eide TJ. Trends in incidence and survival of mesenchymal neoplasm of the digestive tract within a defined population of Northern Norway. APMIS. 2006;114:192–200.CrossRefPubMed Steigen SE, Eide TJ. Trends in incidence and survival of mesenchymal neoplasm of the digestive tract within a defined population of Northern Norway. APMIS. 2006;114:192–200.CrossRefPubMed
12.
Zurück zum Zitat Ahmed I, Welch NT, Parsons SL. Gastrointestinal stromal tumors (GIST)—17 years experience from Mid Trent Region (United Kingdom). Eur J Surg Oncol. 2008;34:445–9.PubMed Ahmed I, Welch NT, Parsons SL. Gastrointestinal stromal tumors (GIST)—17 years experience from Mid Trent Region (United Kingdom). Eur J Surg Oncol. 2008;34:445–9.PubMed
13.
Zurück zum Zitat Tran T, Davila JA, El-Serag HB. The epidemiology of malignant gastrointestinal stromal tumors: An analysis of 1, 458 cases from 1992 to 2000. Am J Gastroenterol. 2005;100:162–8.CrossRefPubMed Tran T, Davila JA, El-Serag HB. The epidemiology of malignant gastrointestinal stromal tumors: An analysis of 1, 458 cases from 1992 to 2000. Am J Gastroenterol. 2005;100:162–8.CrossRefPubMed
14.
Zurück zum Zitat Dematteo RP, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumors: Recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231:51–8.CrossRefPubMed Dematteo RP, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumors: Recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231:51–8.CrossRefPubMed
15.
Zurück zum Zitat Bümming P, Ahlman H, Andersson J, et al. Population-based study of the diagnosis and treatment of gastrointestinal stromal tumours. Br J Surg. 2006;93:836–43.CrossRefPubMed Bümming P, Ahlman H, Andersson J, et al. Population-based study of the diagnosis and treatment of gastrointestinal stromal tumours. Br J Surg. 2006;93:836–43.CrossRefPubMed
16.
Zurück zum Zitat Kim KM, Kang DW, Moon WS, et al. Gastrointestinal stromal tumors in Koreans: its incidence and the clinical, pathologic and immunohistochemical findings. J Korean Med Sci. 2005;20:977–84.CrossRefPubMed Kim KM, Kang DW, Moon WS, et al. Gastrointestinal stromal tumors in Koreans: its incidence and the clinical, pathologic and immunohistochemical findings. J Korean Med Sci. 2005;20:977–84.CrossRefPubMed
17.
Zurück zum Zitat Nilsson B, Bumming P, Meis-Kindblom JM, 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.CrossRefPubMed Nilsson B, Bumming P, Meis-Kindblom JM, 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.CrossRefPubMed
18.
Zurück zum Zitat Rutkowski P, Nowecki ZI, Michej W, et al. Risk criteria and prognostic factors for predicting recurrences after resection of primary gastrointestinal stromal tumor. Ann Surg Oncol. 2007;14:2018–27.CrossRefPubMed Rutkowski P, Nowecki ZI, Michej W, et al. Risk criteria and prognostic factors for predicting recurrences after resection of primary gastrointestinal stromal tumor. Ann Surg Oncol. 2007;14:2018–27.CrossRefPubMed
19.
Zurück zum Zitat Brainard JA, Goldblum JR. Stromal tumors of the jejunum and ileum: a clinicopathologic study of 39 cases. Am J Surg Pathol. 1997;21:407–16.CrossRefPubMed Brainard JA, Goldblum JR. Stromal tumors of the jejunum and ileum: a clinicopathologic study of 39 cases. Am J Surg Pathol. 1997;21:407–16.CrossRefPubMed
20.
Zurück zum Zitat Tworek JA, Appelman HD, Singleton TP, et al. Stromal tumors of the jejunum and ileum. Mod Pathol. 1997;10:200–9.PubMed Tworek JA, Appelman HD, Singleton TP, et al. Stromal tumors of the jejunum and ileum. Mod Pathol. 1997;10:200–9.PubMed
21.
Zurück zum Zitat Miettinen M, Sarlomo-Rikala M, Sobin LH, et al. Gastrointestinal stromal tumors and leiomyosarcomas in the colon: a clinicopathologic, immunohistochemical, and molecular genetic study of 44 cases. Am J Surg Pathol. 2000;24:1339–52.CrossRefPubMed Miettinen M, Sarlomo-Rikala M, Sobin LH, et al. Gastrointestinal stromal tumors and leiomyosarcomas in the colon: a clinicopathologic, immunohistochemical, and molecular genetic study of 44 cases. Am J Surg Pathol. 2000;24:1339–52.CrossRefPubMed
22.
Zurück zum Zitat Miettinen M, Shekitka KM, Sobin LH. Schwannomas in the colon and rectum: a clinicopathologic and immunohistochemical study of 20 cases. Am J Surg Pathol. 2001;25:846–55.CrossRefPubMed Miettinen M, Shekitka KM, Sobin LH. Schwannomas in the colon and rectum: a clinicopathologic and immunohistochemical study of 20 cases. Am J Surg Pathol. 2001;25:846–55.CrossRefPubMed
23.
Zurück zum Zitat Hasegawa T, Matsuno Y, Shimoda T, et al. Gastrointestinal stromal tumor: consistent CD117 immunostaining for diagnosis, and prognostic classification based on tumor size and MIB-1 grade. Hum Pathol. 2002;33:669–76.CrossRefPubMed Hasegawa T, Matsuno Y, Shimoda T, et al. Gastrointestinal stromal tumor: consistent CD117 immunostaining for diagnosis, and prognostic classification based on tumor size and MIB-1 grade. Hum Pathol. 2002;33:669–76.CrossRefPubMed
24.
Zurück zum Zitat Orosz Z, Tornóczky T, Sápi Z. Gastrointestinal stromal tumors: a clinicopathologic and immunohistochemicalstudy of 136 cases. Pathol Oncol Res. 2005;11:11–21.CrossRefPubMed Orosz Z, Tornóczky T, Sápi Z. Gastrointestinal stromal tumors: a clinicopathologic and immunohistochemicalstudy of 136 cases. Pathol Oncol Res. 2005;11:11–21.CrossRefPubMed
25.
Zurück zum Zitat Alvarado-Cabrero I, Vázquez G, Sierra Santiesteban FI, et al. Clinicopathologic study of 275 cases of gastrointestinal stromal tumors: The experience at 3 large medical centers in Mexico. Ann Diagn Pathol. 2007;11:39–45.CrossRefPubMed Alvarado-Cabrero I, Vázquez G, Sierra Santiesteban FI, et al. Clinicopathologic study of 275 cases of gastrointestinal stromal tumors: The experience at 3 large medical centers in Mexico. Ann Diagn Pathol. 2007;11:39–45.CrossRefPubMed
26.
Zurück zum Zitat Miettinen M, Sobin LH, Lasota J. Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol. 2005;29:52–68.CrossRefPubMed Miettinen M, Sobin LH, Lasota J. Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol. 2005;29:52–68.CrossRefPubMed
27.
Zurück zum Zitat Trupiano JK, Stewart RE, Misick C, et al. Gastric stromal tumors: a clinicopathologic study of 77 cases with correlation of features with nonaggressive and aggressive clinical behaviors. Am J Surg Pathol. 2002;26:705–14.CrossRefPubMed Trupiano JK, Stewart RE, Misick C, et al. Gastric stromal tumors: a clinicopathologic study of 77 cases with correlation of features with nonaggressive and aggressive clinical behaviors. Am J Surg Pathol. 2002;26:705–14.CrossRefPubMed
28.
Zurück zum Zitat Miettinen M, Makhlouf H, Sobin LH, et al. Gastrointestinal stromal tumors of the jejunum and ileum: a clinicopathologic, immunohistochemical, and molecular genetic study of 906 cases before imatinib with long-term follow-up. Am J Surg Pathol. 2006;30:477–89.CrossRefPubMed Miettinen M, Makhlouf H, Sobin LH, et al. Gastrointestinal stromal tumors of the jejunum and ileum: a clinicopathologic, immunohistochemical, and molecular genetic study of 906 cases before imatinib with long-term follow-up. Am J Surg Pathol. 2006;30:477–89.CrossRefPubMed
29.
Zurück zum Zitat Iesalnieks I, Rümmele P, Dietmaier W, et al. Factors associated with disease progression in patients with gastrointestinal stromal tumors in the pre-imatinib era. Am J Clin Pathol. 2005;124:740–48.CrossRefPubMed Iesalnieks I, Rümmele P, Dietmaier W, et al. Factors associated with disease progression in patients with gastrointestinal stromal tumors in the pre-imatinib era. Am J Clin Pathol. 2005;124:740–48.CrossRefPubMed
30.
Zurück zum Zitat Medeiros F, Corless CL, Duensing A, et al. KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications. Am J Surg Pathol. 2004;28:889–94.CrossRefPubMed Medeiros F, Corless CL, Duensing A, et al. KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications. Am J Surg Pathol. 2004;28:889–94.CrossRefPubMed
Metadaten
Titel
Gastrointestinal stromal tumors: a clinicopathological and immunohistochemical study of 121 cases
verfasst von
Mukul Vij
Vinita Agrawal
Ashok Kumar
Rakesh Pandey
Publikationsdatum
01.11.2010
Verlag
Springer-Verlag
Erschienen in
Indian Journal of Gastroenterology / Ausgabe 6/2010
Print ISSN: 0254-8860
Elektronische ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-010-0079-z

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