Zhao Wen-Yi, Xu Jia, Wang Ming, Zhang Zi-Zhen, Tu Lin, Wang Chao-Jie, Lin Tian-Long, Shen Yan-Yin, Liu Qiang, Cao Hui
Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
Int J Clin Exp Pathol. 2014 Apr 15;7(5):2298-304. eCollection 2014.
Ki67 index is one of the most important immunocytochemical markers of proliferation in tumors, but the criterion of Ki67 index in GISTs was not well-defined yet. Our study aims to fully evaluate the prognostic value of Ki67 index in GIST patients and efficiency of imatinib adjuvant therapy.
Clinicopathological data were confirmed by pathological diagnosis and clinical recorders. Recurrence-free survivals (RFS) were evaluated in 418 GIST patients (370 cases only taken the surgery and 48 high-risks taken imatinib adjuvant therapy after R0 resection).
Two cutoff levels of Ki67 index (>5 and >8%) were established in our study through statistical analysis. Ki67 index (≤5, 6-8 and >8%) is an independent prognostic factor for RFS of GIST patients. Ki67 index>8% can precisely sub-divide high-risk GISTs effectively with different outcomes, and high-risk patients with Ki67 index>8% showed a poorer prognosis even with imatinib adjuvant therapy.
Ki67 index is an effective complementation of modified NIH criteria in predicting the prognosis of GISTs, and Ki67 index>8% may act as an unfavorable factor for imatinib adjuvant therapy.
Ki67指数是肿瘤增殖最重要的免疫细胞化学标志物之一，但GISTs中Ki67指数的标准尚未明确界定。我们的研究旨在全面评估Ki67指数在GIST患者中的预后价值以及伊马替尼辅助治疗的疗效。
临床病理数据经病理诊断和临床记录确认。对418例GIST患者（370例仅接受手术，48例高危患者在R0切除后接受伊马替尼辅助治疗）的无复发生存期（RFS）进行评估。
通过统计分析，我们的研究确定了Ki67指数的两个临界值水平（>5%和>8%）。Ki67指数（≤5%、6%-8%和>8%）是GIST患者RFS的独立预后因素。Ki67指数>8%能够有效地精确细分高危GISTs，且具有不同的预后结果，即使接受伊马替尼辅助治疗，Ki67指数>8%的高危患者预后也较差。
Ki67指数是改良NIH标准预测GISTs预后的有效补充，且Ki67指数>8%可能是伊马替尼辅助治疗的不利因素。
