Gloeckner K, Rudolph P, Feller A C
Institut für Pathologie, Universität Lübeck.
Verh Dtsch Ges Pathol. 1998;82:253-60.
Stromal tumors of the gastrointestinal tract (GIST) constitute a group of phenotypically heterogenous mesenchymal neoplasms with uncertain biological behaviour.
We examined 31 cases of paraffin-embedded GIST histologically and immunohistochemically in regard to their proliferation. Mitosis were counted, atypical mitosis were noted. Proliferation was measured immunohistochemically by Ki-S5 expression and cytophotometrically by ploidy. Prognostic factors were evaluated and compared to the clinical behaviour.
Mitosis counts with a mean of 6.43/10 HPF (range: 0-51). Eight atypical mitosis were noted of which five had mitosis counts of 10 or less. Proliferation index determined by Ki-S5 was 9.47% (range: 0-30%). Nineteen tumors were aneuploid. Prognostic unfavorable factors included younger age at diagnosis, male sex, muscular differentiation, higher cellularity and site (stomach VS intestine). KAPLAN-MEIER analysis revealed a statistical significance for Ki-S5 index (p = 0.00268) and ploidy (p = 0.0014). Mitosis counts > 10/10 HPF as well as atypical mitosis were associated with an aggressive biological behaviour.
There are different prognostic factors to determine the prognosis of GISTs., e.g. Ki-S5 index, ploidy, mitosis counts and atypical mitosis. Ki-S5 index seems to be the most reliable.
胃肠道间质瘤（GIST）是一组表型异质性的间叶性肿瘤，其生物学行为尚不确定。
我们对31例石蜡包埋的GIST进行了组织学和免疫组织化学检查，以了解其增殖情况。计数有丝分裂，记录非典型有丝分裂。通过Ki-S5表达进行免疫组织化学测量增殖，并通过倍性进行细胞光度测量。评估预后因素并与临床行为进行比较。
有丝分裂计数平均为6.43/10高倍视野（范围：0-51）。记录到8例非典型有丝分裂，其中5例有丝分裂计数为10或更低。通过Ki-S5确定的增殖指数为9.47%（范围：0-30%）。19个肿瘤为非整倍体。预后不良因素包括诊断时年龄较小、男性、肌肉分化、较高的细胞密度和部位（胃与肠）。KAPLAN-MEIER分析显示Ki-S5指数（p = 0.00268）和倍性（p = 0.0014）具有统计学意义。有丝分裂计数>10/10高倍视野以及非典型有丝分裂与侵袭性生物学行为相关。
有不同的预后因素来确定GIST的预后，例如Ki-S5指数、倍性、有丝分裂计数和非典型有丝分裂。Ki-S5指数似乎是最可靠的。
