Gastrointestinal stromal tumor(GIST)の臨床病理学的検討

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Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the digestive tract. In addition, high-grade GISTs are known to show wide variability in their clinical malignant behavior. Initial tumor size and mitotic index (MI) are the most useful parameters to predict malignant potential and are used in risk assessment classification to assess prognosis of primary GISTs. In this study, we examined 39 cases of GIST, which were immunohistochemically positive for CD117 (<I>c-kit</I>), from 58 cases of mesenchymal tumors of the gastrointestinal tract. We focused on the correlation between the risk assessment classification and other clinicopathological features to establish helpful and reproducible parameters to indicate malignant potential and to serve practically and objectively in the routine histopathological diagnosis of GIST. The results showed that there were statistically significant differences in the SMA positive groups between high and low grade GISTs. Furthermore, high mitotic index groups showed a statistically significant difference between“metastasis/ recurrence”and “non-metastasis/recurrence”groups. Results show that MI is useful to assess the malignant potential of GIST. We analyzed the internal tandem duplication (ITD) in the FMS-like tyrosine kinase-3 gene (FLT3/ ITD mutation) in GIST. However, we did not detect an FLT3/ITD mutation in any of the 28 GISTs suggesting that the FLT3/ITD mutation is not present or very rare in GIST.
学校法人昭和大学・昭和医学会の論文

Gastrointestinal stromal tumor(GIST)の臨床病理学的検討

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