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High mitotic index associated with poor prognosis in gastrointestinal autonomic nerve tumour
Author(s) -
Tornóczky T,
Kálmán E,
Hegedûs G,
Horváth Ö P,
Sápi Z,
Antal L,
Jáksó P,
Pajor L
Publication year - 1999
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1046/j.1365-2559.1999.00685.x
Subject(s) - pathology , immunohistochemistry , mitotic index , gist , synaptophysin , biology , flow cytometry , stomach , stromal cell , mitosis , medicine , immunology , microbiology and biotechnology
Aims Three gastrointestinal autonomic nerve tumours (GANT) were characterized by immunohistochemistry and flow cytometry. Two of the three cases occurred in the small intestine, while the third was found in the stomach. Besides the immunohistochemical and ultrastructural description, the aim of this study was to examine the relation between the known and accepted predictive factors (ploidy data, the S‐phase fraction, the mitotic and MIB‐1 index and the size of the tumour) and the survival of the patients. Methods and results The immune profile showed that 3/3 cases were vimentin and NSE, 2/3 were synap‐tophysin and PGP 9.5 positive, while 1/3 also showed S100 positivity. Ultrastructurally, all the cases had dense core granules, one of them contained skenoid fibres. The flow cytometry revealed diploid DNA in all cases, however, significant differences could be seen in the proliferative activity of the individual neoplasms. Conclusions In spite of the published data of gastrointestinal stromal tumours (GIST) generally, neither the MIB‐1 index and the ploidy data nor the size of the primary tumour helped to predict the clinical progression of the examined GANTs. However, the high proliferative activity (57 mitoses/10 HPF) and the elevated S‐phase fraction (24%) was associated with advanced, metastatic and recurring disease in case 3. On the basis of these three cases, high mitotic activity is the most reliable factor in predicting aggressive clinical behaviour.