[Application and evaluation of biologic potential grading criteria for localized gastrointestinal stromal tumors].
OBJECTIVE
To evaluate the implication of Fletcher and Miettinen biologic potential grading criteria in native localized gastrointestinal stromal tumors (GISTs).


METHODS
Two hundred and twenty localized GISTs with complete clinicopathologic and follow-up data were evaluated for their biologic potential by Fletcher and Miettinen grading criteria. The implication of the two grading criteria were compared by survival analysis.


RESULTS
Evaluated by Fletcher grading criteria, the overall and disease-free survival rate of high risk GISTs was lower than that of very-low, low and intermediate GISTs; while the overall and disease-free survival rate of very-low, low and intermediate risk GISTs had no statistical diffence. In the high risk GISTs, the overall and disease-free survival rate of small intestinal and rectal GISTs was lower than that of gastric GISTs; while in the intermediate risk GISTs, the disease-free survival rate of small intestinal GISTs was lower than that of gastric GISTs. Evaluated by Miettinen grading criteria, the overall and disease-free survival rate of high risk GISTs was lower than that of very-low, low and intermediate GISTs; while the overall and disease-free survival rate of very-low, low and intermediate risk GISTs had no statistical difference. In the risk subgroup of GISTs, the overall and disease-free survival rate of gastric, small intestinal and rectal GISTs had no statistical difference.


CONCLUSIONS
Fletcher grading criteria is simple and easy to use; while Miettinen grading criteria for evaluating biological potential by anatomic site is more critical and has important reference implication for the selection of high risk patients for targeted adjuvant treatment.
Shi
En-yi
EY
Department of Pathology, Cancer Hospital Affiliated to Fudan University, and Department of Oncology, Fudan University Shanghai Medical College, Shanghai 200032, China.
Hou
Ying-yong
YY
Tan
Yun-shan
YS
Zhou
Xiao-yan
XY
Cai
Xu
X
Lu
Yong-ming
YM
Zhu
Xiong-zeng
XZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology*; D006801:Humans; D007078:Ileal Neoplasms / Q000473:pathology*; D007580:Jejunal Neoplasms / Q000473:pathology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000473:pathology*; D018570:Risk Assessment / Q000379:methods / Q000592:standards*; D013274:Stomach Neoplasms / Q000473:pathology*; D015996:Survival Rate; D055815:Young Adult