Takeyama Hiromitsu, Funahashi Hitoshi, Sawai Hirozumi, Takahashi Hiroki, Yamamotorm Minoru, Akamo Yoshimi, Manabe Tadao
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya 4678601, Japan.
Med Sci Monit. 2007 Feb;13(2):CR51-6.
Gastrointestinal stromal tumors (GISTs) are the most common non-epithelial neoplasms of the gastrointestinal tract. The aim of this study was to investigate the clinicopathological and immunohistochemical features of gastric GISTs and to evaluate the degree of integrin expression in order to determine the need for surgery or predict the prognosis for GIST patients.
MATERIAL/METHODS: Clinicopathological findings were obtained from patients' records. Specimens from 32 cases of gastric GIST were analyzed with immunohistochemical methods. The c-kit negative examples among the original 48 patients with gastric submucosal and muscle layer tumors were excluded from the study.
There was a significant correlation between p53 protein expression and tumor malignancy. The positive staining for proliferating cell nuclear antigen was observed in all patients, and the mean tumor proliferation index for benign and malignant groups were 3.0% and 16.3%, respectively. alpha5beta1 integrin and alpha6 integrin subunit were expressed from moderately to strongly in tumor cells, and alpha 6 integrin subunit expression correlated significantly with whether tumors were classified as benign or malignant. However, there were no significant differences between the survival of GIST patients and integrin expression, mitotic rate, tumor size, or tumor malignancy.
Malignant GISTs show significant expression of alpha6 integrin subunit. It may be useful in supporting other parameters, such as p53, MI, and tumor size. We suggest that alpha6 integrin subunit expression may be useful as an indication for surgery and also as one of several prognostic factors.
胃肠道间质瘤(GISTs)是胃肠道最常见的非上皮性肿瘤。本研究旨在探讨胃GISTs的临床病理及免疫组化特征,并评估整合素表达程度,以确定GIST患者的手术需求或预测其预后。
材料/方法:从患者记录中获取临床病理结果。采用免疫组化方法分析32例胃GISTs标本。最初48例胃黏膜下层和肌层肿瘤患者中c-kit阴性的病例被排除在研究之外。
p53蛋白表达与肿瘤恶性程度显著相关。所有患者均观察到增殖细胞核抗原阳性染色,良性和恶性组的平均肿瘤增殖指数分别为3.0%和16.3%。α5β1整合素和α6整合素亚单位在肿瘤细胞中呈中度至强表达,α6整合素亚单位表达与肿瘤分类为良性或恶性显著相关。然而,GIST患者的生存率与整合素表达、有丝分裂率、肿瘤大小或肿瘤恶性程度之间无显著差异。
恶性GISTs显示α6整合素亚单位显著表达。它可能有助于支持其他参数,如p53、MI和肿瘤大小。我们认为α6整合素亚单位表达可能作为手术指征以及几个预后因素之一有用。