Comparative ultrastructural analysis and KIT/PDGFRA genotype in 125 gastrointestinal stromal tumors Journal Article


Authors: Agaram, N. P.; Baren, A.; Arkun, K.; DeMatteo, R. P.; Besmer, P.; Antonescu, C. R.
Article Title: Comparative ultrastructural analysis and KIT/PDGFRA genotype in 125 gastrointestinal stromal tumors
Abstract: GISTs are the most common mesenchymal neoplasms of the digestive tract and are thought to originate from or differentiate toward the interstitial cell of Cajal lineage. Almost all GISTs express KIT protein and the majority show activating mutations in either KIT or PDGFRA proto-oncogenes. Ultrastructurally, these tumors have been shown to have either a smooth muscle, neuronal, dual, or null phenotype. The objective of this study was to investigate the relationship between ultrastructural features and genotype in a large series of 125 histologically confirmed and CD117 positive GISTs. PCR analysis for the presence of KIT exon 9, 11, 13, and 17 and PDGFRA exon 12 and 18 mutations was performed. There were 62 (50%) tumors located in the stomach and 45 (36%) in the small bowel. Overall, KIT mutations were detected in 93 (75%) patients: 86 (69%) in exon 11, and 7 (6%) in exon 9. A PDGFRA mutation was detected in 7 (6%) cases and 25 (19%) cases had no mutation. Ultrastructurally, skeinoid fibers were seen in 55 (44%) cases and were more common in small bowel than stomach GISTs, and occurred in only in 1 of 16 patients with an ITD (KIT) exon 11 or PDGFRA mutation. Focal actin microfilaments were identified in 82 (65%) cases and did not correlate with location or mutation type. Rare neurosecretory-type granules (NS-G) were seen in 34 (27%) of cases, but were seen in most of the cells in only 5 (4%) cases. GISTs showing both NS-G and microtubules were associated with KIT exon 11 genotype and spindle cell morphology. PDGFRA mutated cases were associated with gastric location, predominantly epithelioid morphology and lacked NS-G. Copyright © Informa Healthcare.
Keywords: immunohistochemistry; human tissue; gene mutation; major clinical study; exon; mutation; polymerase chain reaction; protein analysis; actin; gastrointestinal stromal tumor; pdgfra; interstitial cell of cajal; gastrointestinal stromal tumors; proto-oncogene proteins c-kit; receptor, platelet-derived growth factor alpha; genotype; correlation analysis; receptor tyrosine kinase; spindle cell; kit; dna mutational analysis; small intestine; microtubule; epithelioid cell; ultrastructure; intestines; stomach; rectum; microscopy, electron, transmission; neurosecretory cell; microfilament
Journal Title: Ultrastructural Pathology
Volume: 30
Issue: 6
ISSN: 0191-3123
Publisher: Informa Healthcare  
Date Published: 2006-11-01
Start Page: 443
End Page: 452
Language: English
DOI: 10.1080/01913120600854186
PUBMED: 17182437
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 6" - "Export Date: 4 June 2012" - "CODEN: ULPAD" - "Source: Scopus"
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MSK Authors
  1. Ronald P DeMatteo
    637 DeMatteo
  2. Narasimhan P Agaram
    190 Agaram
  3. Cristina R Antonescu
    895 Antonescu
  4. Peter Besmer
    115 Besmer
  5. Ann Baren
    9 Baren
  6. Knarik Arkun
    8 Arkun