Analysis of prognostic and clinicopathologic factors in gastrointestinal stromal tumors of the stomach / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To identify the clinical pathological characteristics and prognostic factors in patients with gastrointestinal stromal tumors of the stomach.</p><p><b>METHODS</b>The data of 98 patients of gastric stromal tumors, leiomyomas, leiomyosarcomas, leiomyoblastomas, schwannomas and neurofibromas, collected from Mar. 1983 to Dec. 2001 in our hospital with complete clinical and pathological data, were investigated retrospectively. Gastric stromal tumors were diagnosed by reviewing the tumor slides stained with hematoxylin and eosin (H&E). Two histomorphologically representative areas of each tumor slides were identified and arrayed on a tissue microarray. Immunohistochemistry staining were performed using antibodies to c-kit (CD117), CD34, smooth muscle actin (SMA), Desmin and S-100 proteins. The relations of various clinicopathologic characteristics and outcomes were tested by univariate analysis and multivariate analysis.</p><p><b>RESULTS</b>Ninety-one patients were clearly identified as gastric stromal tumors from the 98 patients, who were diagnosed as gastric stromal tumor, leiomyoma, leiomyosarcoma, leiomyoblastoma schwannoma and neurofibroma (92.9%). The follow-up rate was 91% and the median follow up time was 54 months. The patient survival rates at 1, 5 and 10 years were 88.8%, 79.6% and 63.7% respectively. Univariate analysis showed that tumor size, mitotic count, tumor necrosis, nuclear pleomorphism, cell type, cell density, surgical procedure, mucosal invasion, age and lable index of Ki-67 were associated with prognosis (P<0.05). Multivariate analysis showed that tumor size, mitotic count, mucosal invasion and tumor necrosis were predictors of prognosis (P<0.05).</p><p><b>CONCLUSION</b>Tumor size of >10 cm, mitotic count of >10 mitoses per 50 high power fields, necrosis and mucosal invasion are often associated with an aggressive clinical course in gastric stromal tumors.</p>

Intra-abdomen extragastrointestinal stromal tumors: a clinicopathologic study on 30 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics and prognostic factors in patients with intra-abdomen extragastrointestinal stromal tumors (EGISTs).</p><p><b>METHODS</b>The data of 47 patients of mesenchymal neoplasms that arose from the abdominal cavity and retroperitoneum, collected from July 1987 to June 2003 in our hospital with complete clinical and pathological data, were investigated retrospectively. EGISTs were diagnosed by reviewing the tumor slides stained with hematoxylin and eosin (H&E). Immunohistochemistry staining were performed on CD117, CD34, smooth muscle actin, Desmin and S-100 proteins. The relations of various clinicopathologic characteristics and outcomes were examined.</p><p><b>RESULTS</b>Among the 47 cases, 30 tumors were confirmed to be EGISTs. Twelve cases arose from the mesentery, six from small omentum, eight from retroperitoneum and four from the abdominal cavity. The size of tumors ranged from 4 to 30 cm (median 12.5 cm) in diameter and the tumor cell components mainly included spindle cells (23 cases), epithelioid cells (4 cases), and mixed cells (3 cases). The follow-up rate was 90% and the median follow up time was 44 months. The patient survival rates at 1, 5 and 10 years were 79.7%, 59.5% and 45.4% respectively. Univariate analysis showed that tumor size >10 cm, tumor necrosis, mitoses > or =5/50HPF, obvious nuclear atypia, moderate and poor differentiated tumor cells were predictors of poor prognosis.</p><p><b>CONCLUSIONS</b>EGISTs have specific clinical behaviors. The parameters used for predicting GISTs prognosis are not completely applicable for EGISTs. Tumor necrosis, obvious nuclear atypia and mitoses > or =5/50HPF help to predict aggressive behaviors in EGISTs.</p>