P53 expression is significantly correlated with high risk of malignancy and epithelioid differentiation in GISTs. An immunohistochemical study of 104 cases

doi:10.1186/1471-2407-8-204

BMC Cancer

Volume 8

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Pauser U
Schmedt auf der Günne N
Klöppel G
Merz H
Feller AC

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Schmedt auf der Günne N
Klöppel G
Merz H
Feller AC
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Research article

P53 expression is significantly correlated with high risk of malignancy and epithelioid differentiation in GISTs. An immunohistochemical study of 104 cases

Ursula Pauser¹ , Nina Schmedt auf der Günne²^,3 , Günter Klöppel² , Hartmut Merz¹ and Alfred C Feller¹

¹Department of Pathology, University of Lübeck, Germany

²Department of Pathology, University of Kiel, Germany

³Department of Gastroenterology, Albertinen Hospital Hamburg, Germany

author email corresponding author email

BMC Cancer 2008, 8:204doi:10.1186/1471-2407-8-204


Published:	23 July 2008

Abstract

Background

Molecular analyses of the c-kit and PDGFRα genes have contributed greatly to our understanding of the development of gastrointestinal stromal tumors (GISTs), but little is known about their malignant potential. The aim of our study was to evaluate cell cycle regulators as potential prognostic markers in GISTs.

Methods

We investigated 104 KIT positive GISTs from various tumor sites in immunoassays on CD34, Ki67 and particularly on P53, BCL-2 and Cyclin D1. The results were compared with tumor size, mitotic rate, proliferative activity, histological subtype, nuclear atypia and risk assessment according to Fletcher and Miettinen. Occurrence of metastases and survival were also taken into account.

Results

The expression of P53 was significantly correlated with high risk criteria towards malignancy and epithelioid differentiation in GISTs. Likewise P53 label correlated significantly with the established prognostic indicators: tumor size, mitotic rate, nuclear atypia and proliferative activity. Regarding the site of tumor presentation, P53 was not a decisive factor. BCL-2 and Cyclin D1 expression was not related to any of the prognostic indicators.

Conclusion

The present data identified P53 being a recommendable marker for predicting the risk of malignancy in GISTs. In addition, we found P53 significantly correlated with epithelioid tumor differentiation, independent of tumor site. BCL-2 and Cyclin D1, however, did not prove to be deciding markers for diagnosis and prognosis.