RISK STRATIFICATION AND PROGNOSIS OF GASTRO-INTESTINAL STROMAL TUMOURS BASED ON IMAGING FINDINGS AND MITOTIC ACTIVITY IN HISTOPATHOLOGY
*Dr. Aarthi Parthasarathy M.D and Dr. Sachin Shatagar M.D
ABSTRACT
Objective: Aim of the study was to establish any helpful and reproducible parameters to indicate malignant potential and be used practically and objectively in the risk of malignant potential diagnosis of GIST. Materials and Methods: All patients with clinically suspected mass or intestinal obstruction, who are referred to our department for abdominal CT scan for evaluation of obstruction and whose follow up regarding surgical or conservative management is available. CT criteria used included the study of tumours under the following headings necrosis, haemorrhage, ulceration calcifications etc. Involvement of the adjacent in the form of metastasis , lymph node encasement, ascites, peritoneal deposits, exophytic vs endophytic component .CT findings were correlated with HPE – classification of spindle cells and mitotic activity and Immunohistochemistry to prove GIST. No mitosis group, low mitosis group and high mitosis group were defined depending on mitotic rates as described previously, Results: Univariate analysis demonstrated that mitotic count, cellularity, haemorrhage, tumour necrosis and p53 immunostaining were correlated significantly with poor prognosis. On multivariate analysis IHC and cellularity were significant independent prognostic factors, however we failed to obtain a sig p value to indicate a mitotic count a s an independent variable. Conclusions: We concluded that given potential for mitotic count in staging GIST and its prognosis according to various literature cited, a similar study can be continued to see its longterm outcome.
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