Cancer Res Treat.  2010 Sep;42(3):135-143.

Clinicopathological and Immunohistochemical Features of Gastointestinal Stromal Tumors

• Kang YN
• Jung HR
• Hwang I

Abstract

PURPOSE
The purpose of this study was to evaluate the clinicopathological features and immunohistochemical features of gastrointestinal stromal tumor (GIST), and specifically the expressions of platelet derived growth factor receptor A (PDGFRA), protein kinase C theta (PKC theta), discovered on GIST-1 (DOG-1), p16 and p27.
MATERIALS AND METHODS
Total 118 patients who underwent surgical resection for GIST at our institution between Jan 1997 and Dec 2007 were retrospectively studied. Immunohistochemical staining for c-kit, PDGFRA, PKC-theta, DOG-1, p16 and p27 was performed on a tissue microarray of the 118 GIST. The clinicopathologic parameters, the disease-free survival (DFS) and the overall survival rate were analyzed along with immunohistochemistry.
RESULTS
The immunohistochemical stains for c-kit, CD34, PKC-theta, PDGFRA, DOG-1, p16 and p27 were positive in 89.8%, 72.0%, 56.8%, 94.9%, 90.7%, 69.5% and 44.1% of the tumor samples, respectively. The immunohistochemical expression of c-kit was strongly correlated with PKC-theta (p=0.000), DOG-1 (p=0.000) and CD34 (p=0.002). The DFS rate was significantly decreased for the patients with peritoneal GIST, high risk GIST, > or =10 cm-sized GIST, > or =10 mitoses/50 high power fields (HPFs) and p16 positivity (p=0.001, p=0.004, p=0.001, p=0.003 and p=0.028). GISTs > or =10 cm, epithelioid tumor cell type, and c-kit, and DOG-1 negativity were significantly associated with shorter period of overall survival (p=0.048, p=0.006, p=0.000 and p=0.000).
CONCLUSION
The expression of p16 and no expression of c-kit and DOG-1 in GISTs, as well as peritoneal tumor site, high risk group, large tumor size, epithelioid tumor cell type and numerous mitoses, may be potentially prognostic factors for predicting worse outcome for patients who suffer from GIST.

Keyword

Gastrointestinal stromal tumors; Immunohistochemistry; Prognosis

MeSH Terms

Coloring Agents
Disease-Free Survival
Gastrointestinal Stromal Tumors
Humans
Immunohistochemistry
Mitosis
Prognosis
Protein Kinase C
Receptors, Platelet-Derived Growth Factor
Retrospective Studies
Survival Rate
Coloring Agents
Protein Kinase C
Receptors, Platelet-Derived Growth Factor

Figure

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  Fig. 1 Disease free survival (DFS) rate of all patients was poor in peritoneal gastrointestinal stromal tumor (GIST) (A), high risk GIST (B), tumor size ≥10 cm (C), mitoses ≥10/50 HPFs (D), and p16 positivity (E). HPF, high power field.

• 

  Fig. 2 Overall survival (OS) rate was also poor in tumor size ≥10 cm (A), epithelioid cell type (B), negative c-kit (C), and negative DOG-1 (D). GIST, gastrointestinal stromal tumor; DOG-1, discovered on GIST-1.

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