The Expression And Clinical Significance Of CD34and Ki-67Proteins In GIST

Background and Objective:GIST(gastrointestinal stromal tumor) occurs mainly in thegastrointestinal tract, but can also occur in other parts, such as themesentery and omentum, it is one type of the source of Mesenchymaltumors. Since most tumors express CD117, some scholars believe that itoriginated in ICC(Interstitial Cells of Cajal), the expression of CD117was high specificity (expression ratio>95%) in the vast majority ofGIST,it can be regarded as the gold standard for the diagnosis of GISTand one of gastrointestinal stromal tumor markers characteristic.CD34is a primitive hematopoietic tissue differentiation antigens anda glycosylated transmembrane protein115kDa, present in humanhematopoietic stem cells and endothelial cells in the bone marrowhematopoietic precursor cell antigen, Initially it was stromal tumors ingastrointestinal examination to CD34, and have higher expression,between about70%to80%of gastrointestinal stromal tumors positive forCD34expression in endothelial cells, fibroblasts and other Some breastcancer Carbonell sarcoma, fibrous tumors also have CD34expression.Occasional cases of CD34-positive and CD117-negative. Joint detection and CD117, CD117is not expressed when, CD34-positive diagnosticreference value, the expression of CD117-negative diagnosis when ahigher value.Ki-67is a cell proliferation associated nuclear antigen, its function isconsidered closely related to mitosis, cell proliferation and cell isindispensable, and its expression with a variety of tumors, development,invasion and metastasis. Ki-67can detect the basic nature of the tumorresponse, this single indicator is too high, it is a dangerous signal, if whileobserving other indicators, the better to predict the true response andtumor development. Between Ki-67and mitotic count certaincorrespondence directly, the degree of reaction cell proliferation, but theKi-67is more accurate, objective, and can more accurately reflect thestatus of cell proliferation, and as a reflection of cell division andproliferation markers.The study of gastrointestinal stromal tumor tissue and normalmucosal tissue of the experimental study, CD34Ki-67expression in thedetection by immunohistochemical staining methods to explore both ingastrointestinal stromal tumors expression and prognostic role. Thepurpose is to reveal CD34and Ki-67protein expression ingastrointestinal stromal tumor tissue, the relationship between them andtheir contact relationship with clinicopathological factors and mutual forgastrointestinal stromal tumors patients prevention, screening, diagnosis, treatment and prognosis.Methods:Selected and collected40gastrointestinal stromal tumors surgicallyresected specimens in surgery in our Hospital March2012to September2013. All selected patients with complete clinical and pathological data,not all patients before surgery, radiotherapy and chemotherapy treatmentwere. All specimens were reviewed by pathologist and followed amongthe Chinese diagnosis and treatment of gastrointestinal stromal tumorexpert consensus (2011edition) was selected diagnosis of gastrointestinalstromal tumors, Including40cases of patients with gastrointestinalstromal tumor specimens cut on confirmed exclude gastrointestinalstromal tumors may normal gastrointestinal mucosa tissue samples. Usebetween immunohistochemical staining SP selected40cases ofgastrointestinal stromal tumor tissue samples and40normalgastrointestinal mucosa tissue slices expression of CD34and Ki-67,andthe expression between normal tissue and pathological features withexisting relationships among both gastrointestinal stromal tumor tissuespecific circumstances.Result：1. The expression of CD117in gastrointestinal stromal tumor tissuewas92.5%(37/40), there is no expression in the normal gastrointestinalmucosa tissue, there was a statistical significance between the expression (P <0.05). It is occasional when CD117not express and CD34express ingastrointestinal stromal tumors (2.5%).2. CD34expression in gastrointestinal stromal tumor tissue was85.0%(33/40), the expression in the normal gastrointestinal mucosatissue was15%(6/40), there was a statistical significance between theexpression (P<0.05). The expression of CD34and location of the tumorwas significantly different (P<0.05) at statistically.But between thepositive expression of CD34in patients with gastrointestinal stromaltumor tissue age, sex, histological type, tumor mitotic count, tumor size,tumor grade of risk, and no statistically significant difference (P>0.05).3. The expression of Ki-67was75.0%(30/40) in gastrointestinalstromal tumor tissues, the positive in normal gastrointestinal mucosatissues rate was7.5%(3/40), between the expression of CD34havestatistical significance (P<0.05). There is no statistical significancedifference between the expression of Ki-67in gastrointestinal stromaltumor tissue with age, sex, tumor location, histological type (P>0.05),there were statistical significance differences with the number of mitotictumor, tumor diameter, the risk of tumor statistics (P <0.05).4．The expression of CD34in gastrointestinal stromal tumors waspositively correlated with the expression of Ki-67and was statisticallysignificant (r=0.494, P <0.05). Conclusion:1.The expression of CD117has a higher rate of gastrointestinalstromal tumors, it can be used as the gold standard of gastrointestinalstromal tumor diagnosis. When the negative expression of CD117, theexpression of CD34can be a diagnosis.2.In GIST, the expression of CD34-positive GIST tumors and relatedparts,no correlation between the expression of CD34and the patient’s age,sex, histological type, tumor mitotic index, tumor size, tumor grade wassignificantly related to the degree of danger, but CD34for gastrointestinalstromal tumors have better diagnostic reference value.3. There is no correlation with expression of Ki-67in GIST tissuebetween age,gender, tumor location, histological type, and the number ofmitotic tumor, tumor size, tumor grade of risk related to the identificationof gastrointestinal stromal tumor between benign and malignantsignificant value can be used as an important indicator of prognosis.4. The expression of CD34in GIST was correlated with theexpression of Ki-67, positively,there may be some synergy between thetwo mechanisms in the development of gastrointestinal stromal tumors,and adjust the expression of CD34and Ki-67in, may provide targets forthe gastrointestinal stromal tumor targeted therapy.