Liang Yu-mei, Li Xiang-hong, Chen Wei
Department of Pathology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2008 Apr 15;88(15):1041-5.
To investigate the roles of risk assessment and Ki-67 index in judging prognostic of gastrointestinal stromal tumors (GISTs).
The clinical data of 102 patients of GIST, 60 with gastric stromal tumor and 42 with small intestinal stromal tumor were collected. The relations of disease free survival rate and disease specific overall survival rate to Ki-67 index and risk assessment were analyzed.
Risk assessment showed that 2 cases were at very low risk, 14 at low risk, 16 at intermediate risk, and 28 at high risk. As classified by the Ki-67 index system, 13 cases were in the group of Ki-67 index > or =5%, and the other 47 cases were in the group of Ki-67 index <5%. The patients with high risk or Ki-67 index > or =5% had significantly lower disease-free survival rates (Pki-67 = 0.001, P risk assessment = 0.044) and disease specific overall survival rates (Pki-67 = 0.001, P risk assessment = 0.007). The high-risk patients had significantly lower survival rate than the patients of other grades (P disease-free = 0.044, P over all = 0.012). In the 42 patients with small intestinal stromal tumor 9 were at low risk, 11 at intermediate risk, and 22 at high risk;and there were 12 cases with Ki-67 index > or =5% and 30 cases with Ki-67 index <5%. Risk assessment had no relationship with disease specific overall survival rate. The overall survival rate of the intestinal stromal tumor patients with the Ki-67 index > or =5% was significantly lower than that of those with the K-67 index <5% (P = 0.039), however, Ki-67 index was not related to disease free survival rate. Four of the gastric stromal tumor patients at low and intermediate risk and with Ki-67 index > or =5% suffered recurrence or metastasis; and 2 similar cases were found in the small intestinal stromal tumor cases.
Risk assessment and Ki-67 index are good prognostic indicators for gastric stromal tumors. In small intestinal stromal tumors, risk assessment is only related to disease free survival rate, and Ki-67 index is related to disease specific overall survival rate. In the GIST patients at low and intermediate risk, Ki-67 can be a good complimentary indicator to predict the recurrence or metastasis.
探讨风险评估和Ki-67指数在判断胃肠道间质瘤（GIST）预后中的作用。
收集102例GIST患者的临床资料，其中胃间质瘤60例，小肠间质瘤42例。分析无病生存率和疾病特异性总生存率与Ki-67指数及风险评估的关系。
风险评估显示，极低风险2例，低风险14例，中风险16例，高风险28例。按Ki-67指数系统分类，Ki-67指数≥5%组13例，Ki-67指数<5%组47例。高风险或Ki-67指数≥5%的患者无病生存率（P Ki-67 = 0.001，P风险评估 = 0.044）和疾病特异性总生存率（P Ki-67 = 0.001，P风险评估 = 0.007）显著较低。高风险患者的生存率显著低于其他分级的患者（P无病 = 0.044，P总体 = 0.012）。42例小肠间质瘤患者中，低风险9例，中风险11例，高风险22例；Ki-67指数≥5%者12例，Ki-67指数<5%者30例。风险评估与疾病特异性总生存率无关。Ki-67指数≥5%的小肠间质瘤患者总生存率显著低于Ki-67指数<5%者（P = 0.039），然而，Ki-67指数与无病生存率无关。4例低、中风险且Ki-67指数≥5%的胃间质瘤患者发生复发或转移；小肠间质瘤患者中发现2例类似情况。
风险评估和Ki-67指数是胃间质瘤良好的预后指标。在小肠间质瘤中，风险评估仅与无病生存率相关，Ki-67指数与疾病特异性总生存率相关。在低、中风险的GIST患者中，Ki-67可作为预测复发或转移的良好补充指标。
