Filiz Gülaydan, Yalçinkaya Olviye, Gürel Selim, Yerci Omer, Memik Faruk
Department of Surgical Pathology, Uludag University, Faculty of Medicine, Bursa, Turkey.
Hepatogastroenterology. 2007 Mar;54(74):438-41.
BACKGROUND/AIMS: Gastrointestinal stromal tumors (GIST) are mesenchymal tumors originating from the gastrointestinal canal wall. Although a number of studies are performed concerning prognostic factors, no indicators of recurrence or metastasis could be established. In this study we assessed the prognostic value of MIB-1 proliferative index (PI) in GIST, and whether there was a relationship to any other clinicopathological findings.
In the study 37 patients with GIST diagnosis were included. The cases were classified as low, intermediate, and high risk groups according to tumor size and mitotic activity. The average PI of 10% in high risk group was set as the cut-off value.
Of all the cases, those with a MIB-1 PI over the cut-off value had a significantly shorter survival (Log-rank test, p < 0.05). Likewise cases with small bowel tumors with a MIB-1 PI over the cut-off value had a significantly shorter survival (Log-rank test, p < 0.05). A statistically significant negative correlation was found between presence of necrosis and survival using McPearson correlation test (p < 0.01).
MIB-1 PI and presence of necrosis are possible indicators of prognosis especially in GIST cases of the small bowel.
背景/目的：胃肠道间质瘤（GIST）是起源于胃肠道管壁的间叶组织肿瘤。尽管针对预后因素进行了大量研究，但尚未确立复发或转移的指标。在本研究中，我们评估了MIB-1增殖指数（PI）在GIST中的预后价值，以及它与其他临床病理表现是否存在关联。
本研究纳入了37例经诊断为GIST的患者。根据肿瘤大小和有丝分裂活性将病例分为低、中、高风险组。将高风险组中10%的平均PI设定为临界值。
在所有病例中，MIB-1 PI超过临界值的患者生存期显著缩短（对数秩检验，p < 0.05）。同样，MIB-1 PI超过临界值的小肠肿瘤患者生存期也显著缩短（对数秩检验，p < 0.05）。使用McPearson相关检验发现坏死的存在与生存期之间存在显著的负相关（p < 0.01）。
MIB-1 PI和坏死的存在可能是预后的指标，尤其是在小肠GIST病例中。
