Prediction Of Aggressive Behavior In Gastrointestinal Stromal Tumors

Objective The aim of this study is to evaluate the prognostic significance of clinicopathologic features in patients with gastrointestinal stromal tumors (GISTs). Tissue microarray technology for high-throughput molecular analyses was used to identify novel prognostic markers. All data were compared against complete mortality / follow-up data for determining which parameters can predict the aggressive behavior of GISTs. Methods The medical records of patients with mesenchymal neoplasm that arise the gastrointestinal tract and abdomen diagnosed and treated between June 1986 and December 2001 were retrieved from the Cancer Hospital, Chinese Academy of Medical Science. Tumor slides stained with hematoxylin and eosin (H&E) from these patients were reviewed. One block representative for the tumor specimen is chosen, a (H&E) stain is prepared, and two histomorphologically representative areas are indentified and arrayed on a tissue microarray. Immunohistochemistry staining were performed using antibodies to c-kit protein (CD117), CD34, smooth muscle actin, Desmin and S-100 protein. GISTs are defined as cellular spindle cell, epithelioid or occasionally pleomorphic mesenchymal tumors of the Gl tract that express c-kit protein (CD117). There are nineteen molecular markers for identifying the prognositic significance of altered expression. The relations of various clinicopathologic characteristic and expression of molecular markers to outcome were tested by univariate analysis using log rank. Multivariate analysis was performed with the Cox proportional hazards model. The validity of the approach for defining risk of aggressive behavior in GISTs proposed by NIH (National Institute of Health) was also tested.