Gastrointestinal stromal tumors in children and young adults: A clinicopathologic, molecular, and genomic study of 15 cases and review of the literature Journal Article
| Authors: | Prakash, S.; Sarran, L.; Socci, N.; DeMatteo, R. P.; Eisenstat, J.; Greco, A. M.; Maki, R. G.; Wexler, L. H.; LaQuaglia, M. P.; Besmer, P.; Antonescu, C. R. |
| Article Title: | Gastrointestinal stromal tumors in children and young adults: A clinicopathologic, molecular, and genomic study of 15 cases and review of the literature |
| Abstract: | Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors of the intestinal tract that typically occur in adults over the age of 40 years. GISTs in younger patients are rare and not well characterized. The objective was to define the characteristics of GISTs in children and young adults (<30 years old). Clinicopathologic and molecular features, including KIT/PDGFRA genotype, in GISTs from 5 children and 10 young adults were analyzed. Gene expression analysis was performed on 5 gastric tumor samples from 2 children, 2 gastric tumors from young adults, and 10 gastric GISTs from older adults using an U133A Affymetrix platform (22,000 genes). All five pediatric GISTs occurred in girls, involved the stomach as multiple nodules, showed predominantly an epithelioid morphology, often involved lymph nodes, and lacked KIT or PDGFRA mutations. Although all five patients developed recurrence (four in the liver, three in the peritoneum, and two in both sites), four are still alive with disease. Of the 10 GISTs in young adults, half occurred in the small bowel and had spindle cell morphology, and one case had lymph node metastasis. KIT mutations were identified in seven cases, four in exon 11 and three in exon 9. Seven patients developed recurrence, and at last follow-up two patients had died of disease. Gene expression analysis showed high expression of PHKA1, FZD2, NLGN4, IGF1R, and ANK3 in the pediatric and young adult versus older adult cases. GISTs that occur in children are a separate clinicopathologic and molecular subset with predilection for girls, multifocal gastric tumors, and wild-type KIT/PDGFRA genotype. In contrast, GISTs in young adults are a more heterogeneous group, including cases that resemble either the pediatric or the older adult-type tumors. The distinct gene expression profile suggests avenues for investigation of pathogenesis and potential therapeutic strategies. Copyright © 2005 by Lippincott Williams & Wilkins. |
| Keywords: | adolescent; adult; child; clinical article; controlled study; human tissue; school child; unclassified drug; gene mutation; human cell; exon; clinical feature; disease course; histopathology; cancer recurrence; antineoplastic agents; conference paper; lymph node metastasis; lymph node dissection; gastrointestinal stromal tumor; imatinib; platelet derived growth factor alpha receptor; stem cell factor; tumor localization; gastrointestinal stromal tumors; proto-oncogene proteins c-kit; receptor, platelet-derived growth factor alpha; neoplasm recurrence, local; gene expression; gene expression profiling; tumor markers, biological; genotype; gene product; pyrimidines; wild type; pediatric; somatomedin c receptor; gene expression regulation, neoplastic; amino acid sequence; molecular sequence data; sequence homology, amino acid; oligonucleotide array sequence analysis; liver tumor; receptor tyrosine kinase; genomics; gastrectomy; protein-tyrosine kinases; piperazines; dna mutational analysis; g protein coupled receptor; peritoneum tumor; stomach tumor; frizzled protein; kit mutation; small intestine tumor; ankyrin; ankyrin 3; frizzled 2 protein; neuroligin 4; phosphorylase kinase alpha 1 |
| Journal Title: | Journal of Pediatric Hematology/Oncology |
| Volume: | 27 |
| Issue: | 4 |
| ISSN: | 1077-4114 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2005-04-01 |
| Start Page: | 179 |
| End Page: | 187 |
| Language: | English |
| DOI: | 10.1097/01.mph.0000157790.81329.47 |
| PUBMED: | 15838387 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 119" - "Export Date: 24 October 2012" - "CODEN: JPHOF" - "Source: Scopus" |
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