위에서 발생한 위장관 간질종양의 임상적 고찰
Clinical Evaluation of Gastrointestinal Stromal Tumor of the Stomach
김태균, 박찬일, 김경수, 김병석, 문덕진, 박주섭,
소속 상세정보
김태균 ( Kim Tae-Gyun )
광주기독병원 외과
박찬일 ( Park Chan-Il )
광주기독병원 외과
김경수 ( Kim Kyung-Soo )
광주기독병원 해부병리과
김병석 ( Kim Byung-Seok )
광주기독병원 외과
문덕진 ( Moon Duk-Jin )
광주기독병원 외과
박주섭 ( Park Joo-Seok )
광주기독병원 외과
KMID : 0371320010610040393
Abstract
Purpose : Despite modern pathologic techniques, GISTs pose a dilemma in nomenclature, cellular origin, diagnosis, classification, and prognostication. The authors attempted to elucidate the clinical applications of known prognostic factors
at our
hospital on the basis of CD34 or CD117 positivity.
Methods : Immunostaining was done on 24 cases of GI tract tumor including leiomyoma, leiomyosarcoma, and GISTs treated in our hospital between 1991 and 2000. 20 cases that showed positive reactivity to either CD34 or CD117 were chosen, and
a
retrograde evaluation of the clinical characteristics and pathological characteristics was done.
Results : 16 of 24 cases (66.7%) showed a positive reactivity to CD34, 18 cases (75%) to CD117, and 20 cases (83.3%) to both CD34 and CD117. Complete resection was performed on all, with exception of one in which intraperitoneal metastasis
was
detected. The mean age of the p
atients was 58.9 (19∼74) years, the mean tumor size was 8.1 ㎝ (3∼20) and there was no significant difference between the sexes. The overall survival rate was 80%. The difference of cumulative survival rate was significant when tumor size was
10
㎝
or greater (p=0.0021), mitotic count was 5/50 HPF or over (p<0.0001), or severe cellularity (p=0.0001), invasion (p<0.0001), necrosis (p=0.0185) or atypism (p<0.0001) were accompanied.
Conclusion : Authors defined GIST as those case that were immunohistochemically positive to either CD34 or CD117. The prognostic factors those affected 5-year survival rate were tumor size, mitotic count, intratumoral necrosis, severe
cellularity, atypism and invasion. Additionally, the surgical treatment for this condition should be a complete resection of macroscopically identified tumor with adequate margin secured. Finally, a long term follow-up for the recurrence should
be
carried out.
키워드
위장관 간질종양; 예후인자; 5년 생존율; GIST; Prognostic factor; 5-year survival rate;
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