Evaluation of the gastrointestinal stromal tumors for clinical features, histopathological findings and prognostic criteria: A case-control study

OBJECTIVE: In this study, we reviewed GISTs with all morphological and immunohistochemical findings and assessed the prognostic parameters of these tumors.
METHODS: Files of 40 cases with GIST operated between 2002 and 2008 were retrospectively examined in this study. Patients were grouped as patients with and without recurrence within postop 1 year. The patients were grouped based on their localization, gender and age. The cases were stratified as the risk grades based on risk categorization table developed by Fletcher et al. according to the tumor diameter and number of mitoses. The cases were immunohistochemically investigated for CD117, CD34, S100, and Ki-67.
RESULTS: Male/female ratio was 25/15. The mean age was 61.55. Mean tumor diameters were statistically significantly higher in the recurrence (+) group than in the recurrence (-) group (p=0.048). The mean number of mitoses was statistically significantly higher in the recurrence (+) group than in the recurrence (-) group (p=0.038). No statistically significant difference was found in histological distribution of the recurrence (-) and recurrence (+) groups (p=0.8795). No statistically significant difference was found in CD34, S100, and Ki-67 distribution of the recurrence (-) and recurrence (+) groups (p=0.862, p=0.609, and p=0.023, respectively). All patients in the recurrence (+) group were in the high-risk group.
CONCLUSION: GISTs are studied in a wide range from benign, incidental tumors to malignant tumors with the risk for recurrence and metastasis concerning biological behaviour. GISTs have prognostic parameters, such as tumor localization, tumor diameter, mitotic index, cellularity, and pleomorphism grade.

Gastrointestinal Stromal Tümörlerin Klinik Özellikler, Histopatolojik Bulgular ve Prognostik Kriterler Açýsýndan Deðerlendirilmesi: Vaka- Kontrol Çalýþma

GÝRÝÞ ve AMAÇ: Çalýþmamýzda GÝST’ler tüm morfolojik ve immunohistokimyasal bulgular ile gözden geçirilmiþ, prognostik parametreleri deðerlendirilmiþtir.
YÖNTEM ve GEREÇLER: 2002-2008 yýllarýnda opere edilen 40 GÝST vakasý, retrospektif olarak incelendi. Postoperatif 1 yýl içinde nüks saptananlar ve saptanmayanlar olarak gruplandýrýldý. Lokalizasyonlarýna, cinsiyetlerine ve yaþlarýna göre gruplandýrýldý. Vakalar tümörün biyolojik davranýþýný göstermek amacýyla, Fletcher ve arkadaþlarýnýn tümör çapý ve mitoz sayýsýna göre hazýrladýðý risk kategorizasyonu tablosu temel alýnarak, risk derecelerine ayrýldý. Vakalar, immunhistokimyasal olarak CD117, CD34, S100, Ki-67 yönünden incelendi.
BULGULAR: Erkek / kadýn oraný 25/15 idi. Yaþ ortalamasý 61.55 idi. Ortalama tümör çaplarý nüks (+) grupta nüks (-) gruba göre istatistiksel olarak anlamlý derecede yüksekti (p = 0.048). Ortalama mitoz sayýsý nüks (+) grupta nüks (-) gruba göre istatistiksel olarak anlamlý derecede yüksekti (p = 0.038). Nüks (-) ve nüks (+) gruplarýnýn histolojik daðýlýmýnda istatistiksel olarak anlamlý bir fark bulunmadý (p = 0.8795). Nüks (-) ve nüks (+) gruplarýnýn CD34, S100 ve Ki-67 daðýlýmlarýnda istatistiksel olarak anlamlý fark bulunmadý (sýrasýyla, p = 0.862, p = 0.609 ve p = 0.023;). Nüks (+) grubundaki tüm hastalar yüksek risk grubunda idi.
TARTIÞMA ve SONUÇ: GÝST’ler biyolojik davranýþ açýsýndan, benign rastlantýsal bulunabilen tümörlerden, nüks ve metastaz riskine sahip, malign tümörlere kadar uzanan geniþ bir yelpazede incelenirler. Tümör lokalizasyonu, tümörün çapý, mitotik indeks, hücresellik, pleomorfizm derecesi gibi prognostik parametreleri bulunur. (NCI-2019-0059.R1)