Jui-Wei Lin

Overexpression of VEGF is associated with positive p53 immunostaining in hepatocellular carcinoma (HCC) and adverse outcome of HCC patients.

To elucidate the clinicopathological correlations among vascular endothelial growth factor (VEGF), microvessel density (MVD) and tumor suppressor gene p53 in hepatocellular carcinomas (HCCs), we adopted a new definition of “VEGF overexpression.”

The Expression and Prognostic Role of Hepatoma-Derived Growth Factor in Colorectal Stromal Tumors

PURPOSE: This study investigated the expression and prognostic role of hepatoma-derived growth factor (HDGF) in colorectal stromal tumor. METHODS: Fifty-two surgically resected colorectal stromal tumors were collected from 1986 to 2006. Immunohistochemical studies were performed with antibodies of HDGF, proliferating cell nuclear antigen (PCNA) and Ki-67. RESULTS: Sixteen patients (30.7 percent) had positive Ki-67 immunostaining. Immunoreactivity to PCNA ranged from 10 to 93 percent. HDGF immunostaining was found in the nucleus (20-95 percent) as well as in the cytoplasm (weak: 16; intermediate: 17; strong: 19). Upregulation of nuclear HDGF levels existed in increased cytoplasmic HDGF levels (P < 0.001). Nuclear HDGF levels were positively correlated with tumor mitotic count (P < 0.001), tumor size (P = 0.002), PCNA (P < 0.001), Ki-67 (P = 0.049), cellular pleomorphism (P = 0.029), and increased National Institutes of Health risk level (P = 0.037). Cytoplasmic HDGF levels were also correlated with PCNA (P = 0.001), tumor mitotic count (P = 0.001), high cellular pleomorphism (P = 0.001), and increased NIH risk (P = 0.043). Kaplan-Meier analyses revealed that patients with high nuclear HDGF (P < 0.001) or cytoplasmic levels (P = 0.001) had shorter disease-free survival than patients with low HDGF levels. Like tumor mitotic count, nuclear HDGF was an independent prognostic factor for patients with colorectal stromal tumors. CONCLUSIONS: This study provides clinicopathologic correlations and prognostic prediction of HDGF expression for the relatively rare colorectal stromal tumors.

Elevated p21 expression is associated with poor prognosis of rectal stromal tumors after resection

The pathogenic role of alteration of cell‐cycle proteins in rectal stromal tumors (GISTs) remains unclear. This study aimed to elucidate the prognostic role of p21 to compare with p53, PCNA, and Ki‐67 in rectal GISTs.

Prognostic Analysis of Rectal Stromal Tumors by Reference of National Institutes of Health Risk Categories and Immunohistochemical Studies

PurposePrognostic analysis of stromal tumors focusing on the rectal area is rarely performed. This study elucidated prognostic factors by referencing biomarkers of Ki67 and p53.MethodsForty-nine surgically resected rectal stromal tumors were collected from 1986 to 2006. Immunohistochemical studies were performed with antibodies of CD117, CD34, smooth muscle actin, desmin, S100, Ki67, and p53.ResultsThe immunoreactivities were: CD34, 83.6 percent; smooth muscle actin, 28.5 percent; S100, 4.1 percent; desmin,16.3 percent;, Ki67, 30.6 percent;, and p53 34.7 percent. Both p53+ and Ki67+ tumors were associated with increased tumor mitosis, increased tumor size, nonspindle cell type, and increased cell pleomorphism (Pu2009<u20090.05). Increased National Institutes of Health risk was associated with old age, nonspindle cell types, and severe nuclear pleomorphism (Pu2009<u20090.05). Survival analysis demonstrated that older patients (Pu2009=u20090.0039), large tumor size (Pu2009=u20090.003), high mitotic count (Pu2009<u20090.001), increased risk categories (Pu2009<u20090.001), high cell pleomorphism (Pu2009=u20090.003), p53+ (Pu2009=u20090.007), and Ki67 + (Pu2009=u20090.002) were prognostic factors for poor disease-free survival. An independent prognostic factor was tumor mitotic count.ConclusionsThis study demonstrated the prognostic role of Ki67 and p53 in rectal stromal tumors. Notably, tumor mitosis was superior for prognostic prediction compared to National Institutes of Health risk categories.

Immunohistochemical analyses of gastric stromal tumors in Taiwanese.

BACKGROUND AND PURPOSEnGastrointestinal stromal tumors (GISTs), identified by the presence of CD117 (KIT), were previously classified as gastric and intestinal smooth muscle tumors prior to the availability of immunohistochemical methods. This study evaluated the percentage of GISTs previously diagnosed as gastric smooth muscle tumors in our hospital during an 11-year period.nnnMETHODSnA total of 81 surgically resected gastric smooth muscle tumor specimens from 81 patients were collected from January 1986 to December 1997. Immunohistochemical studies were performed on these tumors with antibodies of CD34, CD117, smooth muscle actin (SMA), S-100, and desmin.nnnRESULTSnAmong the 81 tumors, 74 (91.4%) were CD117-positive and were classified as GISTs. Among the 74 GISTs, CD34 was positive in 72 tumors (97.3%), SMA was positive in 12 tumors (16.2%), desmin was positive in 5 tumors (6.7%), and S-100 was positive in 4 tumors (5.4%). The 7 tumors classified as non-GISTs had the following immunohistochemical characteristics: 1 was a CD117-negative CD34-positive stromal tumor (GINST) [1/81, 1.2%]; 3 were schwannomas with strong S-100-positive characteristics (3/81, 3.7%); and 3 were smooth muscle tumors with both SMA- and desmin-positive status (3/81, 3.7%). No clear relationship between CD117 or CD34 expression and prognosis was found for these tumors.nnnCONCLUSIONSnThe majority (91.4%) of gastric tumors originally diagnosed as gastric smooth muscle tumors were GISTs, except for small groups of smooth muscle tumors and schwannomas.

Clinicopathological characteristics and prognosis of patients with small intestinal stromal tumors.

BACKGROUND AND PURPOSEnGastrointestinal stromal tumors (GISTs) involving the small intestine are less common than those involving the stomach, and data on small intestinal stromal tumors (SISTs) are more limited. This study investigated the clinicopathological characteristics and prognostic factors of SISTs and compared them with those of gastric stromal tumors (GSTs).nnnMETHODSnA total of 82 surgically resected and pathologically diagnosed smooth muscle tumors of small bowel in patients treated from January 1986 to December 2000 were included. Immunohistochemical studies were performed on these tumors with antibodies of CD117, CD34, smooth muscle actin (SMA), desmin and S-100. The results were analyzed and compared with 74 cases of GSTs diagnosed and treated from January 1986 to December 1997.nnnRESULTSnAmong the 82 small intestine tumors, 71 were CD117-positive (86.6%) and were classified as SISTs. Of the 71 SISTs, 70.4% were immunoreactive to CD34, 88.7% to SMA, 46.5% to S-100, but none to desmin. Survival analysis demonstrated that tumor size < 5 cm (p = 0.021), mitosis number < 5/50 high-power field (p < 0.001), SMA-positive (p = 0.027), non-epithelioid cell type (p = 0.005) and tumor with skeinoid fibers (p = 0.010) predicted longer disease-free survival after operation. Multivariate analysis revealed that mitotic number (p = 0.001), cell morphology (p = 0.031) and tumor size (p = 0.004) were independent prognostic factors. In comparison to GSTs, SISTs exhibited significantly lower rates of CD34, but significantly higher rates of SMA and S-100 immunoreactivity.nnnCONCLUSIONSnSISTs exhibited a different immunophenotype from GSTs. SMA reactivity is a predictor of benign clinical behavior in SISTs. Tumor mitotic numbers, tumor size, and cell type were independent prognostic factors for patients with SISTs after operation.