J Pathol Transl Med.  2019 Nov;53(6):361-368. 10.4132/jptm.2019.08.27.

Molecular and Clinicopathological Features of Gastrointestinal Stromal Tumors in Vietnamese Patients

• Ngo QD
• Pham QT
• Phan DA
• Hoang AV
• Hua TN
• Nguyen ST

• KMID: 2465435
• DOI: http://doi.org/10.4132/jptm.2019.08.27

Abstract

BACKGROUND
Gastrointestinal stromal tumors (GISTs) are the most frequent mesenchymal neoplasms of the gastrointestinal tract. Management of GIST patients is currently based on clinicopathological features and associated genetic changes. However, the detailed characteristics and molecular genetic features of GISTs have not yet been described in the Vietnamese population.
METHODS
We first identified 155 patients with primary GIST who underwent surgery with primary curative intent between 2011 and 2014 at University Medical Center at Ho Chi Minh City, Vietnam. We evaluated the clinicopathological features and immunohistochemical reactivity to p53 and Ki-67 in these patients. Additionally, KIT genotyping was performed in 100 cases.
RESULTS
The largest proportion of GISTs was classified as high-risk (43.2%). Of the 155 GISTs, 52 (33.5%) were positive for Ki-67, and 58 (37.4%) were positive for p53. The expression of Ki-67 and p53 were correlated with mitotic rate, tumor size, risk assessment, and tumor stage. Out of 100 GIST cases, KIT mutation was found in 68%, of which 62 (91.2%) were found in exon 11, two (2.9%) in exon 9, and four (5.8%) in exon 17. No mutation in exon 13 was identified. Additionally, KIT mutations did not correlate with any clinicopathological features.
CONCLUSIONS
The expression of Ki-67 and p53 were associated with high-risk tumors. Mutations in exon 11 were the most commonly found, followed by exon 17 and exon 9. Additionally, KIT mutation status was not correlated with any recognized clinicopathological features.

Keyword

Gastrointestinal stromal tumors; Ki-67; p53; KIT mutation

MeSH Terms

Academic Medical Centers
Asian Continental Ancestry Group*
Exons
Gastrointestinal Stromal Tumors*
Gastrointestinal Tract
Humans
Molecular Biology
Risk Assessment
Vietnam

Figure

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  Fig. 1. Histopathological and immunohistochemical analysis of gastrointestinal stromal tumor. (A) Epithelioid cell morphology. (B) Spindle cell morphology. (C) Mixed type. Immunohistochemical expression of CD117 (D), smooth muscle actin (E), neuron-specific enolase (F), p53 (G), and Ki-67 (H).

• 

  Fig. 2. KIT mutation in gastrointestinal stromal tumor. (A) In-frame deletion in exon 11. (B) Point mutation in exon 11. (C) Insertion mutation in exon 9. (D) Point mutation in exon 17.

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