Abstract
ObjectivesGastrointestinal stromal tumors (GISTs) are rare tumors of gastrointestinal tract, prognosis of which largely depends upon histopathologic characteristics of resection specimens, which were not widely studied in our population. Therefore we aimed to evaluate the histopathologic characteristics of GISTs in our population and their prognostic grouping according to college of American pathologist’s guidelines.ResultsMean age of patients was 53.4 years (18–71 years). 92% of cases were of primary GISTs and stomach was the most common site (57.7%). 75% of cases were of spindle cell morphology and 53.8% belonged to high risk prognostic group. Comparison of stomach and intestinal GISTs showed that intestinal GISTs were found to be of high grade (70%) and of high risk prognostic group (75 and 80%) compared to stomach GISTs (43% were of high risk prognostic group), however this finding was not statistically significant. GISTs are infrequent gastrointestinal tumors but early diagnosis and identification of adverse histological features are key to successful treatment. We found a large majority of GISTs to be located in stomach, however intestinal GISTs were found more likely to be associated with adverse prognostic parameters. However more large scale studies are warranted to establish this finding.
Highlights
ResultsMean age of patients was 53.4 years (18–71 years). 92% of cases were of primary Gastrointestinal stromal tumors (GISTs) and stomach was the most common site (57.7%). 75% of cases were of spindle cell morphology and 53.8% belonged to high risk prognostic group
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gut, overall they still account for < 1% of all gastrointestinal tumors [1]
The pathologic parameters of GISTs in resection specimens are important in guiding post-operative management and determining prognosis of the patients, these features have not been widely studied in our population
Summary
Stomach predominated with 62.5% followed by small intestine (20.8%) and large intestine (16.7%) This was consistent with the findings of most of the other Asian literature. But it was noted that the stomach contained all three types of morphology patterns while 100% of the cases of the small intestinal GISTs were of spindle cell morphology and the large intestinal GISTS were seen. CD117 was positive in 46 cases and negative in 2 These findings are consistent with many other Asian studies in which CD117 and CD34 positivity has been seen in most GISTs, followed by ASMA and S-100 [10, 13, 16, 18]. On the other hand Feng et al studied small intestinal GISTs and found jejunal and ileal GISTs to be comparable in terms of prognosis [21]
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