In 43 cases of gastrointestinal stromal tumors (GIST) of the stomach (age 20 – 85 years; 21f, 22m) seen at the Klinikum rechts der Isar in Munich between 1981 and 1996 we investigated the prognostic significance of well established histological prognostic factors (size, mitotic count, differentiation, cellularity, necrosis) and the new markers MIB1 and p53. The evaluation was based on metastasis as nproof of malignancy. In 5 cases we found metastatic growth during the follow up (5 - 102 months). We also looked at the expression of sm-actin, desmin, S100, estrogen and progesteron in all lesions. The following results were found: Age, sex, isolated histological growth features or indicating pre op symptoms are not of any prognostic value to clinical behaviour. R0 resection by local excision is as good as extended operation conserning the risk of metastatic growth. Tumor size > 5cm, mitotic count >= 10/50 HPF and MIB 1 Index >4% combined with over expression of p53 in GIST with common histological growth pattern are a strong indication of malignant behaviour. There are no other valuable histological prognostic factors. All tumors were negative for estrogen and progesteron receptor expression. We found sm-actin, desmin, and S100 as usual. We actualized our results based on the consensus approach by Fletcher et al..
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In 43 cases of gastrointestinal stromal tumors (GIST) of the stomach (age 20 – 85 years; 21f, 22m) seen at the Klinikum rechts der Isar in Munich between 1981 and 1996 we investigated the prognostic significance of well established histological prognostic factors (size, mitotic count, differentiation, cellularity, necrosis) and the new markers MIB1 and p53. The evaluation was based on metastasis as nproof of malignancy. In 5 cases we found metastatic growth during the follow up (5 - 102 months)...
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