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Prognostic Value of Her2/neu Expression in Gastrointestinal Stromal Tumors: Immunohistochemical Study

View Article: PubMed Central - PubMed

ABSTRACT

Background: Gastrointestinal stromal tumor (GIST) is a relatively rare type of neoplasms. In Egypt, it represents 2.5% of gastrointestinal tumors and 0.3% of all malignancies. Most of the GISTs develop in the stomach.

Aim: To reveal the significance of Her2/neu immunohistochemical expression in GIST and its correlation with other histopathologic parameters and tumor relapse after regular follow-up.

Patients and methods: This study is a retrospective and prospective cohort. It included 32 patients with GISTs, who were resectable with no distant metastasis. Immunohistochemical staining by Her2/neu was performed after complete surgical resection of the tumors with preservation of the pseudocapsule.

Results: In total, 53.1% of cases were men and 46.9% women. Tumors were classified into low-risk (25%), intermediate-risk (21.9%), and high-risk groups (53.1%). Her2/neu expression was negative in 56.3% of GISTs and positive in 43.7%. Its expression was significantly correlated with risk grade (P = .04), tumor size (P = .001), mitotic count (P = .00), and increased risk of relapse (P = .00). Furthermore, tumor relapse was significantly correlated with the tumor mitotic counts (P = .00). Using kappa agreement test, it showed that 4 mitotic counts/50 high-power fields (HPF) was the cutoff value with which the tumor might be associated more with relapse, with 83% sensitivity, 70% specificity, and P value of .003.

Conclusions: Her2/neu might be used as an independent prognostic marker for tumor recurrence after complete resection of GIST, and the cutoff value of mitotic count that might predict tumor relapse is 4/50 HPF. However, more clinical studies with greater number of cases with fluorescent in situ hybridization integration are recommended.

No MeSH data available.


Related in: MedlinePlus

High-grade mitotically active gastrointestinal stromal tumor showing mixed type of epithelioid (white arrow) and spindle cell differentiation (red arrow) together with focal area of tumor necrosis (blue arrow) (hematoxylin-eosin, original magnification ×100).
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f1-10.1177_1179064417690543: High-grade mitotically active gastrointestinal stromal tumor showing mixed type of epithelioid (white arrow) and spindle cell differentiation (red arrow) together with focal area of tumor necrosis (blue arrow) (hematoxylin-eosin, original magnification ×100).

Mentions: Histopathologic data revealed that 17 cases had high-risk (53%), 7 had intermediate-risk (22%), and 8 had low-risk tumors (25%). Furthermore, microscopic examination revealed spindle cell configuration in 20 tumors (62.5%), epithelioid in 8 (25%), and mixed differentiation in 4 (12.5%) (Table 1, Figure 1).


Prognostic Value of Her2/neu Expression in Gastrointestinal Stromal Tumors: Immunohistochemical Study
High-grade mitotically active gastrointestinal stromal tumor showing mixed type of epithelioid (white arrow) and spindle cell differentiation (red arrow) together with focal area of tumor necrosis (blue arrow) (hematoxylin-eosin, original magnification ×100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5392021&req=5

f1-10.1177_1179064417690543: High-grade mitotically active gastrointestinal stromal tumor showing mixed type of epithelioid (white arrow) and spindle cell differentiation (red arrow) together with focal area of tumor necrosis (blue arrow) (hematoxylin-eosin, original magnification ×100).
Mentions: Histopathologic data revealed that 17 cases had high-risk (53%), 7 had intermediate-risk (22%), and 8 had low-risk tumors (25%). Furthermore, microscopic examination revealed spindle cell configuration in 20 tumors (62.5%), epithelioid in 8 (25%), and mixed differentiation in 4 (12.5%) (Table 1, Figure 1).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Gastrointestinal stromal tumor (GIST) is a relatively rare type of neoplasms. In Egypt, it represents 2.5% of gastrointestinal tumors and 0.3% of all malignancies. Most of the GISTs develop in the stomach.

Aim: To reveal the significance of Her2/neu immunohistochemical expression in GIST and its correlation with other histopathologic parameters and tumor relapse after regular follow-up.

Patients and methods: This study is a retrospective and prospective cohort. It included 32 patients with GISTs, who were resectable with no distant metastasis. Immunohistochemical staining by Her2/neu was performed after complete surgical resection of the tumors with preservation of the pseudocapsule.

Results: In total, 53.1% of cases were men and 46.9% women. Tumors were classified into low-risk (25%), intermediate-risk (21.9%), and high-risk groups (53.1%). Her2/neu expression was negative in 56.3% of GISTs and positive in 43.7%. Its expression was significantly correlated with risk grade (P = .04), tumor size (P = .001), mitotic count (P = .00), and increased risk of relapse (P = .00). Furthermore, tumor relapse was significantly correlated with the tumor mitotic counts (P = .00). Using kappa agreement test, it showed that 4 mitotic counts/50 high-power fields (HPF) was the cutoff value with which the tumor might be associated more with relapse, with 83% sensitivity, 70% specificity, and P value of .003.

Conclusions: Her2/neu might be used as an independent prognostic marker for tumor recurrence after complete resection of GIST, and the cutoff value of mitotic count that might predict tumor relapse is 4/50 HPF. However, more clinical studies with greater number of cases with fluorescent in situ hybridization integration are recommended.

No MeSH data available.


Related in: MedlinePlus