J Korean Med Sci.  2005 Dec;20(6):977-984. 10.3346/jkms.2005.20.6.977.

Gastrointestinal Stromal Tumors in Koreans: It's Incidence and the Clinical, Pathologic and Immunohistochemical Findings

Affiliations
  • 1Department of Pathology, The Catholic University of Korea, Seoul, Korea.
  • 2Department of Pathology, Eulji University, Daejeon, Korea.
  • 3Department of Pathology, Chunbuk National University, Jeonju, Korea.
  • 4Department of Pathology, Catholic University of Daegue, Daegu, Korea.
  • 5Department of Pathology, Sungkyunkwan University, Seoul, Korea.
  • 6Department of Pathology, Dong-A University, Busan, Korea.
  • 7Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 8Department of Pathology, Soonchunhyang University, Seoul, Korea.
  • 9Department of Pathology, Korea University, Seoul, Korea.
  • 10Department of Pathology, Chungnam National University, Daejeon, Korea. dykang@cnu.ac.kr

Abstract

Seven hundred forty seven cases of gastrointestinal stromal tumors (GISTs) in Koreans who were diagnosed between 2001 and 2002 were analyzed to evaluate their occurrence and their clinical, pathologic and immunohistochemical findings. The most frequent location of tumor was in the stomach (63%), followed by the small intestine (30%), the colorectum (5%), and the esophagus (2%). c-kit expression was found in 93.6% of the cases, while CD34, SMA and S-100 protein was positive in 80.1%, 28.2%, and 20.2%, respectively. c-kit positivity was high in the stomach (94.2%) and small intestine (94.6%), while it was relatively low in the colorectum (85.0%), and esophagus (81.2%). The positivity for CD34 was correlated with the higher risk of GISTs (p=0.04). Follow up of the patients showed that 58 primary GISTs patients died and 20 of these patients were recurrent or metastatic at the time of diagnosis. The pathologic diagnosis to predict the risk of aggressive behavior of GISTs was correlated with the numbers of tumor, clinical stage, epithelioid histologic type, cellularity, cellular atypia, necrosis, and mucosal invasion (p= 0.00). GISTs with a poor prognosis were closely related to the clinical stage at presentation, the locations of the tumor, and the ages of the patients.

Keyword

Gastrointestinal Stromal Tumors; Immunohistochemistry; Incidence; Esophagus; Stomach; Intestine, small; Colon; Rectum; Korean

MeSH Terms

Actins/metabolism
Adolescent
Adult
Aged
Aged, 80 and over
Antigens, CD34/metabolism
Child
Female
Gastrointestinal Stromal Tumors/*epidemiology/metabolism/pathology
Humans
Immunohistochemistry
Korea/epidemiology
Male
Middle Aged
Prognosis
Proto-Oncogene Proteins c-kit/metabolism
Research Support, Non-U.S. Gov't
S100 Proteins/metabolism

Figure

  • Fig. 1 Distribution of the ages of the patients with gastrointestinal stromal tumors in 747 patients.

  • Fig. 2 Distribution of the sizes of the gastrointestinal stromal tumors.

  • Fig. 3 Anatomic locations of the gastrointestinal stromal tumors.

  • Fig. 4 Clinical stages of the patients at the time of diagnosis.

  • Fig. 5 Photograph of the representative findings of gastrointestinal stromal tumors. (A) Epithelioid type GIST. (B) Spindle cell type GIST. (C) Mixed epithelioid and spindle cell type GIST. (D) hyaline changes observed in GIST. (E) Myxoid changed observes in GIST. (F) Ischemic tumor necrosis observed in GIST. (G) Mucosal invasion observed in the small intestinal mucosa. (H) Skeinoid fibers observed in the small intestinal GIST. (I) Paraganglioma-like patterns observed in the small intestinal GIST.

  • Fig. 6 c-kit expression according to the pathologic diagnosis defining the risk of aggressive behavior for the gastrointestinal stromal tumors.


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