Correlation Between Ki-67 And Clinicopathological Features And Prognosis In Gastrointestinal Stromal Tumors

Purpose: Due to the diversity of biological behavior,gastrointestinal stromal tumor(GIST)patients cannot be distinguished by simple benign and malignancy,surgical resection is still the main treatment.There was a number of risk assessment systems for primary resectable GIST recurrence.Currently,NIH2008 modified GIST risk classification system is the main method,but the risk classification system is not completely accurate,which prompts us to look for more prognostic factors to evaluate the clinical prognosis of GIST more accurately.In this study,the clinic pathological characteristics and postoperative follow-up data of patients with gastrointestinal stromal tumor were analyzed to explore the correlation between ki-67 labeling index and clinicopathological characteristics and prognosis,so as to provide evidence for individualized treatment of gastrointestinal stromal tumor patients.Methods: 1.The clinical and pathological data of 210 patients with gastrointestinal stromal tumor admitted to the department of surgery of Fujian Cancer Hospital from January 2007 to December 2015 were retrospectively analyzed,and the correlation between ki-67 labeling index and clinicopathological factors was analyzed.2.The prognostic survival data of 210 patients with GIST were followed up,and the value of ki-67 labeling index in the prognosis evaluation of GIST patients was analyzed by kaplan-meier and Cox regression analysis.Results: 1.There was a statistically significant difference between ki-67 labeling index and tumor primary site,tumor size,mitotic index,risk stratification and desmin in GIST patients(p<0.05),and there was a positive correlation between ki-67 proliferation index and tumor size(r=0.286),mitotic index(r=0.378),and risk stratification(r=0.405).There was no significant difference between ki-67 proliferation index and patients' gender,age,DOG-1,CD117,CD34,SAM,S-100(p>0.05).2.For 210 GIST patients,the postoperative follow-up rate was 87.1%,and the median follow-up time was 63 months.34 cases died,and the 5-year survival rate was 83.8%.The 5-year survival rates of patients with ki-67<5% and ki-67?5% were respectively 90.8% and 74.4%,and the difference between the two groups was statistically significant(2 =12.071,p=0.001).Univariate analysis showed that tumor site,tumor size,mitotic,risk grade and ki-67 were related factors affecting the prognosis of patients.COX multivariate analysis showed that tumor location,tumor size,ki-67,and the use of targeted drugs were independent factors affecting the prognosis of patients in the whole group(p<0.05).3.In addition,stratified analysis showed that ki-67 still had a prognostic effect when these patients were stratified by tumor size,mitotic index,and risk stratification.Especially in the population of middle and high-risk patients,the 5-year survival rate with ki-67?5% is lower than ki-67<5%,which may help to distinguish more high-risk patients clinically,so as to develop a more reasonable targeted treatment and follow-up program.Conclusion: Ki-67 labeling index is related to the primary location,tumor size,mitotic index,risk stratification and desmin of GIST.Ki-67 labeling index can be used as one of the important prognostic indicators for GIST patients.Especially in patients with medium-high risk GIST,it may be helpful to clinically distinguish patients with higher risk and develop more reasonable targeted treatment and follow-up plans.