Clinicopathological features of Gastrointestinal Stromal Tumors and review of the literature

Year 2022, Volume: 14 Issue: 2, 373 - 379, 29.06.2022

Sinem Kantarcıoğlu Coşkun

https://doi.org/10.18521/ktd.1094503

Abstract

Objective: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasias of the gastrointestinal system (GIS). The malignancy potential of GISTs may vary ranging from indolent tumors to progressive malignant tumors. This study aims to define clinicopathological and immunohistochemical features of GISTs diagnosed in our institute with a review of the literature.
Method: A total of 28 GIST cases were included in the study. The Hematoxylin&Eosin stained slides of surgical resection materials and cell blocks and immunohistochemistry performed slides were reviewed by a pathologist. The immunohistochemical expression with CD117, DOG-1, CD34, SMA, and S100 was scored between 0 and 3 points according to staining intensity. Descriptive statistics were used in the study. The demographic data, prognostic histopathological, and immunohistochemical findings are evaluated with the literature indications.
Result: Eleven of the cases were male and seventeen were female. The age range was 18-88. The most common site of GISTs was the stomach, followed by the small intestine, colorectal region, and, esophagus. Twenty of the tumors were resected surgically, four were endoscopic biopsy material and four were fine-needle aspiration biopsies. The tumor size in measurable materials ranged from 0,2 to 22 cm. The mitotic count in 50 HPF ranges from 0 to 10. Seven of the GISTs were high grade and the remaining 21 were low grade. The majority of the cases were composed of spindle cells, 3 were epithelioid and 3 were the mixed type with spindle and epitheloid cells.
Conclusion: A variety of criteria has been proposed to estimate the malignancy potential of GISTs and predict prognosis but definite prognostic criteria remain uncertain. Further studies with larger series of GISTs consisting of different types of biopsy materials may help define criteria to predict prognosis precisely.

Keywords

gastrointestinal stromal tumors, CD117, DOG-1, CD34, prognosis

Gastrointestinal Stromal Tümörlerin Klinikopatolojik Özellikleri ve Literatürün Gözden Geçirilmesi: Tek Merkez Deneyimi

Abstract

Amaç: Gastrointestinal stromal tümörler (GİST) gastrointestinal sistemin en sık görülen
mezenşimal neoplazileridir. GİST’lerin malignite potansiyeli indolen tümörlerden progresif
malign tümörlere kadar değişken olabilir. Bu çalışmada merkezimizde tanı almış GİST’lerin
klinikopatolojik ve immünohistokimyasal özelliklerini literatür eşliğinde gözden geçirmek
amaçlanmıştır.
Gereç ve Yöntem: Toplam 28 GİST olgusu çalışmaya dahil edilmiştir. Cerrahi rezeksiyon
materyalleri ile hücre bloklarından hazırlanan Hematoksilen&Eozin boyalı preparatlar ile
immünohistokimya uygulanmış preparatlar patoloji uzmanı tarafından değerlendirilmiştir.
CD117, DOG-1, CD34, SMA ve S100 immünohistokimyasal ekspresyonları boyanma
yoğunluğuna göre 0-3 puan arasında skorlanmıştır. Çalışmada deskriptif istatistikler
kullanılmıştır. Demografik bulgular, prognostik histopatolojik ve immünohistokimyasal
sonuçlar literatür eşliğinde değerlendirilmiştir.
Bulgular: Olguların 11’i erkek, 7’si kadındı. Yaş aralığı 18-88 arasındaydı. GİST’ler için en sık
görülen lokasyon mide olup bunu ince barsak, kolorektal bölge ve özofagus takip etmekteydi.
Tümörlerin 20’si cerrahi olarak çıkarılmış olup, 4’ü endoskopik biyopsi, kalan 4’ü ince iğne
aspirasyon biyopsi materyaliydi. Tümör çapı ölçülebilen materyallerde tümör çapı 0,2 ile 22 cm
arasındaydı. 50 büyük büyütme alanında mitoz sayısı 0 ile 10 arasındaydı. GİST’lerin 7’si
yüksek dereceli, 21’i düşük dereceliydi. Olguların çoğunluğu iğsi hücrelerden oluşmakta olup,
3’ü epiteloid, 3’ü mikst tipteydi.
Sonuç: GİST’lerin malignite potansiyelini tahmin etmek için çeşitli kriterler öne sürülmüş olsa
da kesin prognostik kriterler belirlenmemiştir. Çeşitli biyopsi materyallerinden oluşan daha
büyük vaka serilerinde yapılacak çalışmalar prognozu daha kesin öngörebilecek kriterlerin
belirlenmesine yardımcı olacaktır.

Keywords

Gastrointestinal Stromal Tümör, CD17, DOG-1, CD34, Prognoz

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