Small intestinal stromal tumors: A clinicopathologic study of 31 tumors

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Abstract
The biologic behavior of gastrointestinal stromal tumors Is difficult to predict, and they can be best studied in a site‐specific fashion. The alms of this study are to analyze the clinicopathologic parameters and assess the prognostic value of p53 (DO‐7) and KI‐67 (MIB‐1) immunoreactivitles in small intestinal stromal tumors (SIST). The hlstopathologic features of 31 SIST were assessed and categorized Into two groups as follows. Group A (clinically aggressive) In which death due to tumor, metastasis, recurrence or relapsed melena were seen (n = 15) and group B (clinically benign; n = 16). For both groups, the period of follow‐up was 30–144 months. p53 overexpression was observed In four tumors (31%) In group A, and In none in group B. For groups A and B, the mean Ki‐67 index was 16.8 ± 12.5 and 8.4 ± 12.6, respectively. Statistical analysis revealed that the significant predictors of malignancy were high cellularity (odds ratio (OR) = 999; 95% confidence interval (Cl) = 0–999); p53 overexpression (OR = 999; Cl = 0–999); size of tumor ± 35 cm (OR = 18.0; Cl = 1.9–171.9); ± 35 mltoses/50 high‐power fields (HPF) (OR = 17.1; Cl = 1.8–165.9); pleomorphism (OR = 17.1; Cl = 1.8–165.9); and necrosis (OR = 11.9; Cl = 2.2–65.1; PP = 0.08). In conclusion, high cellularity, p53 overexpression, size of tumor ± 35 cm, ± 35 mitoses/50 HPF, pleomorphism and necrosis are important parameters for the prediction of malignancy in SIST.