Does Immunohistochemistry Provide Additional Prognostic Data in Gastrointestinal Stromal Tumors?

Demir, Lutfiye; Ekinci, Nese; Erten, Cigdem; Kucukzeybek, Yuksel; Alacacioglu, Ahmet; Somali, Isil; Can, Alper; Dirican, Ahmet; Bayoglu, Vedat; Akyol, Murat; Cakalagaoglu, Fulya; Tarhan, Mustafa Oktay

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자료유형: 학술저널

저자정보: Demir, Lutfiye (Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University) Ekinci, Nese (Department of Pathology, Ataturk Training and Research Hospital, Izmir Katip Celebi University) Erten, Cigdem (Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University) Kucukzeybek, Yuksel (Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University) Alacacioglu, Ahmet (Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University) Somali, Isil (Department of Medical Oncology, Institute of Oncology, Dokuz Eylul University) Can, Alper (Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University) Dirican, Ahmet (Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University) Bayoglu, Vedat (Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University) Akyol, Murat (Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi Univ) Cakalagaoglu, Fulya Tarhan, Mustafa Oktay

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제14권 제8호

발행연도: 2013.1

수록면: 4,751 - 4,758 (8page)

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Background: To investigate the predictive and prognostic effects of clinicopathologic and immunohistochemical (IHC) features in patients with gastrointestinal stromal tumours (GISTs). Materials and Methods: Fifty-six patients who were diagnosed with GIST between 2002 and 2012 were retrospectively evaluated. Relationships between clinicopathologic/immunohistochemical factors and prognosis were investigated. Results: Median overall survival (OS) of the whole study group was 74.9 months (42.8-107.1 months), while it was 95.2 months in resectable and 44.7 months in metastatic patients respectively (p=0.007). Epitheliolid tumor morphology was significantly associated with shortened OS as compared to other histologies (p=0.001). SMA(+) tumours were significantly correlated with low (<10/50HPF) mitotic activity (p=0.034). Moreover, SMA(+) patients tended to survive longer and had significantly longer disease-free survival (DFS) times than SMA (-) patients (37.7 months vs 15.9 months; p=0.002). High Ki-67 level (${\geq}30%$) was significantly associated with shorter OS (34 vs 95.2 months; 95%CI; p=0.001). CD34 (-) tumours were significantly associated with low proliferative tumours (Ki-67<%10) (p=0.026). Median PFS (progression-free survival) of the patients who received imatinib was 36 months (27.7-44.2 months). CD34 (-) patients had significantly longer PFS times than that of negative tumours; (50.8 vs 29.8 months; p=0.045). S100 and desmin expression did not play any role in predicting the prognosis of GISTs. Multivariate analysis demonstrated that ${\geq}10/50HPF$ mitotic activity/HPF was the only independent factor for risk of death in GIST patients. Conclusions: Despite the negative prognostic and predictive effect of high Ki-67 and CD34 expression, mitotic activity remains the strongest prognostic factor in GIST patients. SMA positivity seems to affect GIST prognosis positively. However, large-scale, multicenter studies are required to provide supportive data for these findings.

#Gastrointestinal stromal tumor #immunohistochemistry #predictive potential #prognosis

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Demir, Lutfiye

소속기관 Department of Medical Oncology, Izmir Katip Celebi University Ataturk Training and Research Hospital