THE EXPRESS OF SOME MARKERS, RISK STRATIFICATION AND THE RELATION WITH THE OTHER RISK FACTORS IN GIST

Abstract

Background: Gastrointestinal Stromal Tumor (GIST) is the most frequent one among the digestive mesenchymal tumors. GIST usually locates under the mucosa of the stomach, esophagus, small intestine, colorectal intestine and evenly sometimes at the mesentery, omentum. Microscopically, GIST appeares as various features. In order to determine the origin of the tumor cell, surgical pathology especially the immunohistochemistry play a key role for the best choice of treatment with the targeted therapy. Objectives: - To study some of the common characteristics of the surgical pathology and immunohistochemistry of GIST. – To apply the GIST Risk Stratification of AFIP 2006 and determine the relation with some of the traditional risk factors. Materials and Method: cross-sectional study of 39 patients diagnosed with GIST at Hue Central Hospital from 6/2011 to 7/2015. Results: the average age 55.87±11.91, the most frequent age 41-60 in both men and women. The tumor size >2-5cm was the most rate 64.1%, GIST mostly located at the stomach, accounting for 48.7%. The spindle cell GISTs were the highest type 87.2%. Immunohistochemistry shown that the positive of CD117, Vimentine, CD34 were 100%, 94.7% and 61.5% respectively. All GISTs were negative for Desmine. The high risk GISTs were the most frequent accounting for 46.2%, following the moderate ones 28.2%, then the low 20.5%, the very low only 5.1%. This study also shown that, there were the relation between the tumor risk level with the tumor necrosis and the mucosa invasion. Conclusion: The application of the Immunohistochemistry with the marker CD117 and the GIST Risk Stratification need carry out for the digestive mesenchymal tumors to choose the best treatment for the patients. Key words: gastrointestinal stromal tumor (GIST), mesenchymal tumor, histopathology, immunohistochemistry