Xiao Lin, Zhang Yiding, Wang Yajie, Liu Lede, Pan Yisheng
Department of General Surgery, Peking University First Hospital, Beijing, China.
Front Surg. 2023 Mar 8;10:1095924. doi: 10.3389/fsurg.2023.1095924. eCollection 2023.
To investigate the correlations between the Ki-67 index and plain-scan computerized tomography (CT) signs and pathological features of gastrointestinal stromal tumor (GIST) tissue.
Data from 186 patients with GIST diagnosed by pathology and immunohistochemistry (IHC) in Peking University First Hospital from May 2016 to May 2022 were analyzed. The patients were divided into two groups: Ki-67 ≤5% and >5%. Correlation analysis, univariate and multivariate Logistic regression analysis were used to explore the correlations between CT signs, pathological features, and Ki-67 expression.
Univariate indicators correlated with the Ki-67 index were mitotic count, pathological grade, tumor hemorrhage, tumor necrosis, tumor size, and tumor density. Multivariate Logistic regression indicated that the mitotic count [odds ratio (OR) 10.222, 95% confidence interval (CI) 4.312-31.039], pathological grade (OR 2.139, 95% CI 1.397-3.350), and tumor size (OR 1.096, 95% CI 1.020-1.190) were independently associated with the Ki-67 expression level. The concordance indexes (C-index) for the pathological features and CT signs models were 0.876 (95% CI 0.822-0.929) and 0.697 (95% CI 0.620-0.774), respectively, with positive predictive values of 93.62% and 58.11% and negative predictive values of 81.29% and 75.89%, respectively. After internal verification by the Bootstrap method, the fitting degree of the pathological features model was found to be better than that of the CT signs model.
Mitotic count, pathological risk grading, and tumor size are independent risk factors correlating with high Ki-67 index. These results indicate that the Ki-67 index reflects tumor malignancy and can predict recurrence and metastasis of GIST.
探讨胃肠间质瘤（GIST）组织中Ki-67指数与平扫计算机断层扫描（CT）征象及病理特征之间的相关性。
分析2016年5月至2022年5月在北京大学第一医院经病理及免疫组织化学（IHC）确诊的186例GIST患者的数据。将患者分为两组：Ki-67≤5%组和>5%组。采用相关性分析、单因素和多因素Logistic回归分析探讨CT征象、病理特征与Ki-67表达之间的相关性。
与Ki-67指数相关的单因素指标有核分裂象计数、病理分级、肿瘤出血、肿瘤坏死、肿瘤大小和肿瘤密度。多因素Logistic回归显示，核分裂象计数[比值比（OR）10.222，95%置信区间（CI）4.312 - 31.039]、病理分级（OR 2.139，95% CI 1.397 - 3.350）和肿瘤大小（OR 1.096，95% CI 1.020 - 1.190）与Ki-67表达水平独立相关。病理特征模型和CT征象模型的一致性指数（C-index）分别为0.876（95% CI 0.822 - 0.929）和0.697（95% CI 0.620 - 0.774），阳性预测值分别为93.62%和58.11%，阴性预测值分别为81.29%和75.89%。经Bootstrap法内部验证后，发现病理特征模型的拟合度优于CT征象模型。
核分裂象计数、病理风险分级和肿瘤大小是与高Ki-67指数相关的独立危险因素。这些结果表明，Ki-67指数反映肿瘤恶性程度，可预测GIST的复发和转移。
