IJCEP Copyright © 2007-All rights reserved.
Int J Clin Exp Pathol 2013;6(6):1038-1045

Original Article
Smooth muscles and stem cells of embryonic guts express KIT, PDGFRRA, CD34 and
many other stem cell antigens: suggestion that GIST arise from smooth muscles and gut
stem cells

Tadashi Terada

Department of Pathology, Shizuoka City Shimizu Hospital, Shimizu, Shizuoka, Japan

Received March 1, 2013; Accepted April 11, 2013; Epub May 15, 2013; Published June 1, 2013

Abstract: Gastrointestinal stromal tumor (GIST) is believed to original from interstitial cells of (ICC) present in Auerbach’s nerve plexus. GIST
frequently shows gain-of-function mutations of KIT and PDGFRA. In practical pathology, GIST is diagnosed by positive immunostaining or KIT
and/or CD34. The author herein demonstrates that human embryonic gastrointestinal tract smooth muscles (HEGITSM) and human embryonic
stem gastrointestinal cells (HEGISC) consistently express KIT, CD34, NCAM, PDGFRA and other stem cell (SC) antigens NSE, synaptophysin,
chromogranin, bcl-2, ErbB, and MET throughout the embryonic development of 7-40 gestational week (GW). CK14 was negative. The author
examines 42 cases (7-40 GW) of embryonic GI tract (EGI). The HEGISM, HEGIST, and gall bladder smooth muscles (SM) were consistently
positive for KIT, CD34, NCAM, PDGFRA, synaptophysin, chromogranin, NSE, bcl-2, ErbB2, and MET in foregut, stomach, GB, midgut, and
hindgut throughout the fetal life (7-40 GW). The stem cells (SC) were seen to create the SM, nerves, ICC, and other all structures of GI tract. In
adult gastrointestinal walls (n=30), KIT, CD34, PDGFRA, and S100 proteins were expressed in Auerbach’s nerve plexus and ICC. The
bronchial and vascular SM of embryos did not express these molecules. In GIST, frequent expressions of KIT (100%, 30/30), CD34 (90%,
27/30), and PDGFRA (83%, 25/30) were seen. In general, characteristics of tumors recapitulate their embryonic life. Therefore, it is strongly
suggested that GIST may be originated from GI SM and/or GI SC in addition to ICC. (IJCEP1303001).

Keywords: GI tract, GIST, smooth muscles, stem cells, stem cell antigens

Address correspondence to: Dr. Tadashi Terada, Department of Pathology, Shizuoka City Shimizu Hospital, Miyakami 1231 Shimizu-Ku,
Shizuoka 424-8636, Japan. Tel: 81-54-336-1111; Fax: 81-54-336-1315; E-mail: piyo0111jp@yahoo.co.jp