Pathology & Oncology Research

, 13:203 | Cite as

Expression of P-glycoprotein and metallothionein in gastrointestinal stromal tumor and leiomyosarcomas. Clinical implications

  • Sofia Pérez-Gutiérrez
  • Ricardo González-Cámpora
  • Joaquín Amérigo-Navarro
  • Antonio Beato-Moreno
  • Maria Sánchez-León
  • María Jesús Pareja Megía
  • Juan Antonio Virizuela-Echaburu
  • Antonio López-Beltrán


We investigated the expression of P-glycoprotein (P-GP) and metallothionein (MT) in a series of 92 GIST and 14 gastrointestinal leiomyosarcomas (GILMS) with the purpose to expand our knowledge on the biological bases of GIST chemo-resistance and to ascertain their significance in patients’ prognosis. P-GP expression was more frequent in GIST than in GI-LMS (83.7% vs. 21.4%, p<0.001), with no difference between low-and high-risk GIST (p=1.000) or low-and high-grade GI-LMS (p=0.538). P-GP expression was unrelated to anatomic location (gastric vs. intestinal) in GIST (39/45 vs. 35/43, p=0.770) and in GI-LMS (0/2 vs. 2/6, p=1.000). MT expression was non-significantly higher in GI-LMS than in GIST (35.7% vs. 14.1%, p=0.060), with no difference between low-and high-risk GIST (p=1.000) or low-and high-grade GI-LMS (p=1.000). MT expression was unrelated to the anatomic location (gastric vs. intestinal) in GIST (7/45 vs. 6/43) and GI-LMS (0/2 vs. 1/6) (p=1.000 and p=0.1000, respectively). Overall tumor-specific survival (p< 0.001) and disease-free survival (p<0.001) were different in GIST as compared with GI-LMS, and the number of events was higher in GI-LMS. When the survival analysis took into consideration P-GP or MT expression, the overall survival in GIST was influenced by the expression of MT (p=0.021) but not by that of P-GP (p=0.638). However, in GI-LMS, P-GP expression influenced disease-free survival (p=0.050); in addition, it is important to recognize the limited value of these results because of the low number of cases involved in the study. Differential expression of P-GP and MT might explain the known variability in response to systemic chemotherapy in these tumors. Detection of P-GP and MT seems to add certain prognostic value in GIST (MT) or GI-LMS (P-GP).

Key words

gastrointestinal stromal tumors GIST leiomyosarcomas P-glycoprotein metallothionein 


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Copyright information

© Arányi Lajos Foundation 2007

Authors and Affiliations

  • Sofia Pérez-Gutiérrez
    • 1
  • Ricardo González-Cámpora
    • 2
  • Joaquín Amérigo-Navarro
    • 3
  • Antonio Beato-Moreno
    • 4
  • Maria Sánchez-León
    • 2
  • María Jesús Pareja Megía
    • 2
  • Juan Antonio Virizuela-Echaburu
    • 5
  • Antonio López-Beltrán
    • 6
  1. 1.Pathology ServiceJuan Ramon Jiménez HospitalHuelva
  2. 2.Department of PathologyVirgen Macarena University Hospital and University of Seville Medical SchoolSeville
  3. 3.Pathology ServiceHospital TorrecárdenasAlmería
  4. 4.Department of Statistic and Operations ResearchUniversity of SevilleSeville
  5. 5.Oncology ServiceVirgen Macarena University HospitalSeville
  6. 6.Department of PathologyReina Sofia University Hospital and Córdoba University Medical SchoolCórdobaSpain

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