Clinical manifestations and prognostic factors in patients with gastrointestinal stromal tumors

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:kk527319
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AIM:To investigate the incidence of CD117-positiveimmunohistochemical staining in previously diagnosedgastrointestinal(GI)tract stromal tumors(GIST)and to analyzethe tumors’ clinical manifestations and prognostic factors.METHODS:We retrospectively reviewed 91 cases with aprevious diagnosis of GI stromal tumor,leiomyoma,orleiomyosarcoma.Tissue samples were assessed withCD117,CD34,SMA and S100 immunohistochemicalstaining.Clinical and pathological characteristics wereanalyzed for prognostic factors.RESULTS:CDl17 was positive in 81(89 %)of 91 tissuesamples.There were 59 cases(72.8 %)positive for CD34,13(16 %)positive for SMA,and 12(14.8 %)positive forS100.There was no gender difference in patients withCD117-positive GIST.Their mean age was 65 years.Therewere 44(54 %)tumors located in the stomach and 29(36 %)in the small intestine.The most frequent presentingsymptoms were abdominal pain and GI bleeding.The meantumor size was 7.5±5.7 cm.There were 35 cases(43.2 %)with tumors>5 cm.The tumor size correlated significantlywith tumor mitotic count and resectability.Tumor size,mitoticcount,and resectability correlated significantly with tumorrecurrence and survival.There was recurrent disease in39 % of our patients,and their mean survival after recurrencewas 16.6 months.Most recurrences were at the primarysite or metastatic to the liver.Twenty-six percent of ourpatients died of their disease.CONCLUSION: Traditional histologic criteria are not specific enough to diagnose GIST. This diagnosis must be confirmed with CD117 immunohistochemical staining. Prognosis is dependent on tumor size, mitotic count, and resectability. AIM: To investigate the incidence of CD117-positive immunohistochemical staining in previously diagnosed gastrointestinal (GI) tract stromal tumors (GIST) and to analyzethe tumors’ clinical manifestations and prognostic factors. METHODS: We retrospectively reviewed 91 cases with a previous diagnosis of GI stromal tumor, leiomyoma , orleiomyosarcoma.Tissue samples were assessed with CD117, CD34, SMA and S100 immunohistochemical stains. Clinical and pathological characteristics werealyzed for prognostic factors.RESULTS: CD17 was positive in 81 (89%) of 91 tissuesamples. There were 59 cases (72.8%) positive for CD34,13 (16%) positive for SMA, and 12 (14.8%) positive for S100. There was no gender difference in patients with CD117-positive GIST.Their mean age was 65 years. Therewe 44 (54%) tumors located in the stomach and 29 (36%) in the small intestine.The most frequent presentingsymptoms were abdominal pain and GI bleeding.The mean size was 7.5 ± 5.7 cm.There were 35 cases (43.2%) with tumors> 5 cm.The tumor size correlated significantly with tumor mitotic count and resectability. Tumor size, mitotic count, and resectability correlated significantly with tumor recurrence and survival. There was recurrent disease in 39% of our patients, and their mean survival after recurrence was 16.6 months. Rest recurrences were at the primarysite or metastatic to the liver. twenty-six percent of our patients died of their disease. CONCLUSION: Traditional histologic criteria are not specific enough to diagnose GIST. This diagnosis must be confirmed with CD117 immunohistochemical staining. Prognosis is dependent on tumor size, mitotic count, and resectability .
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