title: Differential diagnosis of gastrointestinal stromal tumor and other spindle cell tumors in the gastrointestinal tract based on immunohistochemical analysis.
abstract: To confirm the usefulness of an immunohistochemical panel of antibodies for KIT (c-kit/CD117), CD34, desmin, smooth-muscle actin (SMA), h-caldesmon (HCD), S-100 protein, neuron-specific enolase (NSE), and beta-catenin, 297 mesenchymal and peripheral nerve-sheath tumors of the gastrointestinal tract and intra-abdominal locations including 211 gastrointestinal stromal tumors (GISTs), 12 leiomyomas, 18 leiomyosarcomas, 17 solitary fibrous tumors (SFTs), 14 schwannomas, and 25 desmoid-type fibromatoses (DTFs) were analyzed immunohistochemically. Consistent (100%) immunoreactivity for KIT, CD34, desmin and S-100, and nuclear accumulation of beta-catenin were detected in GISTs, SFTs, smooth-muscle tumors, schwannomas, and DTFs, respectively. Immunoreactivity for SMA, HCD, and NSE was observed in a wide range of these tumors. In addition, 418 bone and soft tissue tumors were enrolled in this study for KIT immunostaining. As a result, a limited number of these tumors were KIT positive, including synovial sarcoma that showed morphological similarity to GISTs. These findings suggest that KIT, CD34, desmin, S-100, and beta-catenin are key markers for clinical diagnosis of GISTs and other spindle cell tumors that may involve the gastrointestinal tract, whereas SMA, HCD, and NSE have only limited value.
authors.affiliation: Divisions of Orthopaedic Oncology, Pathology and Clinical Laboratory, National Cancer Centre Hospital and Research Institute, Tokyo, Japan.
authors.forename: Umio
authors.initials: U
authors.lastname: Yamaguchi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Taizo
authors.initials: T
authors.lastname: Masuda
authors.forename: Shigeki
authors.initials: S
authors.lastname: Sekine
authors.forename: Akira
authors.initials: A
authors.lastname: Kawai
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Chuman
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Shimoda
mesh_terms: D018952:Antigens, CD34 / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000032:analysis*; D001859:Bone Neoplasms / Q000175:diagnosis / Q000378:metabolism; D003893:Desmin / Q000378:metabolism; D003937:Diagnosis, Differential; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D018218:Neoplasms, Fibrous Tissue / Q000175:diagnosis / Q000378:metabolism; D009379:Neoplasms, Muscle Tissue / Q000175:diagnosis / Q000378:metabolism; D018317:Nerve Sheath Neoplasms / Q000175:diagnosis / Q000378:metabolism; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism; D009418:S100 Proteins / Q000378:metabolism; D012509:Sarcoma / Q000175:diagnosis / Q000378:metabolism; D017154:Stromal Cells / Q000378:metabolism / Q000473:pathology
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D003893:Desmin; D009418:S100 Proteins; D019009:Proto-Oncogene Proteins c-kit