Korean J Gastroenterol.  2014 Aug;64(2):87-92. 10.4166/kjg.2014.64.2.87.

Prognostic Significance of Ki-67 Expression in Patients Undergoing Surgical Resection for Gastrointestinal Stromal Tumor

• Jeong SY
• Park WW
• Kim YS
• Park YI
• Kim SH
• Yoon WJ
• Moon JS
• Lee BM
• Hong SW
• Kang YK

• KMID: 2164418
• DOI: http://doi.org/10.4166/kjg.2014.64.2.87

Abstract

BACKGROUND/AIMS
Assessment of malignant potential in gastrointestinal stromal tumor (GIST) is still problematic. The maximum tumor diameter and the mitotic index are generally used as an index of malignancy of GISTs. The Ki-67 labeling index has recently been used as an index of cell growth. The aim of this study was to investigate the prognostic value of Ki-67 in GIST.
METHODS
We retrospectively reviewed the medical records of 32 patients with GIST who underwent surgical resection at Inje University Seoul Paik Hospital. We analyzed their Ki-67 expression, histologic finding, and prognosis.
RESULTS
According to the tumor size and mitotic count, 4 patients were classified as very low risk, 9 patients as low risk, 14 patients as intermediate risk and 5 patients as high risk. The average Ki-67 index was 5.56+/-4.48%. The median follow-up duration was 35.72+/-29.04 months, and local/distant recurrences were observed in 6 (18.7%) patients. The overall cumulative disease free survival rates in patients with Ki-67 index < or =5% at 1 year, 2 years, and 5 years were 100%, 100%, and 86%, respectively. The overall cumulative disease free survival rates in patients with Ki-67 index >5% were at 1 year, 2 years, and 5 years were 82.1%, 70.3%, and 46.9%, respectively. There was significant relationship between elevated Ki-67 and disease free survival rate (p=0.007).
CONCLUSIONS
Our study suggests that Ki-67 index >5% confers a higher risk of relapse in patients with GIST. Future work should focus on standardization of Ki-67 assessment and specification of its role in making treatment decisions.

Keyword

Gastrointestinal stromal tumors; Ki-67 antigen; Prognosis

MeSH Terms

Adult
Aged
Disease-Free Survival
Female
Gastrointestinal Neoplasms/*diagnosis/mortality/pathology
Gastrointestinal Stromal Tumors/*diagnosis/mortality/pathology
Humans
Immunohistochemistry
Kaplan-Meier Estimate
Ki-67 Antigen/*metabolism
Linear Models
Male
Middle Aged
Neoplasm Recurrence, Local
Prognosis
Retrospective Studies
Ki-67 Antigen

Figure

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  Fig. 1. Immunohistochemical staining for Ki-67 (×100). (A) Ki-67 index ≤5%. (B) Ki-67 index ＞5%.

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  Fig. 2. Kaplan-Meier curves show that Ki-67 index ＞5% confers a higher risk of relapse in patients with gastrointestinal stromal tumor (p=0.007).

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  Fig. 3. Correlation between tumor size and Ki-67 index. Spearman's rank correlation coefficient r=0.174 (p＜0.174).

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  Fig. 4. Correlation between mitotic count and Ki-67 index. Spearman's rank correlation coefficient r=0.827 (p＜0.001).

Reference

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