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Microvessel Density (Chalkley Method) in a Series of 79 Gastrointestinal Stromal Tumors
Luiz Eduardo Waengertner1, Luise Meurer2, Marcelle Reesink Cerski2
1Programa de Pos Graduacao, Ciencias em Gastroenterologia, RS, Brazil; Servico de Patologia do Hospital de Clinica de Porto Alegre, RS, Brazil.
Insights
Microvessel density (MVD) in gastrointestinal stromal tumors (GISTs) is a significant predictor of patient survival. The Chalkley method effectively evaluates MVD, aiding in clinical outcome assessment for GIST patients.
Area of Science:
- Oncology
- Pathology
- Medical Imaging
Background:
- Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract.
- Microvessel density (MVD) is a potential prognostic marker in various cancers, including GISTs.
- The modified Chalkley method (MVD) is a technique used to quantify MVD.
Purpose of the Study:
- To evaluate the utility of the modified Chalkley method (MVD) for assessing microvessel density in GISTs.
- To determine the correlation between MVD and patient survival rates in GISTs.
- To investigate the association of MVD with clinicopathological factors in GISTs.
Main Methods:
- Immunohistochemical analysis of CD31, an endothelial marker, was performed on 79 GIST cases.
- Microvessel density was quantified using the Chalkley count method with a 25-point grid on scanned images.
- A cutoff of six vessels was used to categorize MVD as high or low.
Main Results:
- The study included 79 GIST cases (42 males, 37 females; average age 58.9 years).
- GISTs were predominantly located in the stomach (45.6%) and small intestine (38.0%).
- A statistically significant difference in survival rate was observed between GISTs with MVD ≤ 6 vessels and MVD ≥ 6 vessels (P = 0.001).
- No significant association was found between MVD and sex, age, histological type, risk category, location, or metastasis.
Conclusions:
- The Chalkley method for MVD assessment is a valuable tool in GISTs.
- MVD, as determined by the Chalkley method, shows a statistically significant correlation with patient survival in GISTs.
- This method may aid in evaluating the clinical outcome of GIST patients.
Background:
Evaluation of the MVD (modified Chalkley method) in a series of 79 cases of GISTs diagnosed by the Pathology Service at the HCPA (Hospital de Clinicas de Porto Alegre) from January 1993 to December 2009.
Methods:
Seventy nine cases of GISTs were submitted to immunohistochemical analysis for CD31, an endothelial marker, to analyze MVD. Hot spots were identified for each case, and the mean numbers of stained blood vessels collected through Chalkley count, with the use of a 25 point grid, placed onto a scanned image. Images were analysed through an image analysis system. We used a cutoff of six vessels.
Results:
Our series was composed of 42 males and 37 females and presented an average age of 58.9 years. GISTs were predominately located in the stomach (45.6%) followed by the small intestine (38.0%). Sixty seven GISTs (84.8%) showed an average of less than six vessels stained by CD31 (MVD) and 12 (15.2%) GISTs an average of more than six vessels. A statistically significant difference was observed between survival rate of patients having GISTs with MVD of ≤ 6 vessels (mean = 2.4, CI 95%: 1.67 - 3.17) and patients having GISTs with MVD of ≥ 6 vessels (mean = 2.4, CI 95%: 1.67 - 3.17), P = 0.001. No association for MVD was observed related to sex, age, histological type, risk category, location and metastasis.
Conclusions:
Seventy nine cases of GISTs diagnosed at a single center in South Brazil were studied for MVD (Chalkley method). There was a statistically significant difference between MVD and the survival rate for these patients. The use of Chalkley method in GISTs may be helpful to evaluate clinical outcome.
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