Ki-67和cyclin D1蛋白表达的检测对胃肠道间质瘤良恶性判断的意义

Significance of the Expression of Ki-67 and CyclinD1 Protein in Differentiating between Malignant and Benign Gastrointestinal Stromal Tumors

目的 探讨Ki -67和cyclinD 1蛋白表达的检测对胃肠道间质瘤(GISTs)良恶性判断的意义。方法 应用免疫组织化学EnVision二步法检测41例GISTs组织中Ki -67和cyclinD1蛋白表达情况。结果 41例GISTs分为良性组(6例)、交界组(13例)和恶性组(2 2例) ,良性组、交界组与恶性组GISTs的Ki- 67标记指数分别为(8.5±3 .9) %、(16.8±8.6) %和(2 1.8%±8.3 ) % ,3组Ki 67标记指数比较有非常显著性差异(P <0 .0 1) ;Ki- 67标记指数与核分裂像数目、肿瘤直径及肿瘤坏死有关。良性组、交界组与恶性组GISTs的cyclinD1阳性表达率分别为16.7% (1/6)、5 3 .8% (7/13 )和68.2 % (15 /2 2 ) ,3个组cyclinD 1阳性表达率比较有显著性差异(P <0 .0 5 ) ,且良性组与交界组以及良性组与恶性组间cyclinD1阳性表达率有显著性差异(P <0 .0 5 ) ,但交界组和恶性组cyclinD1阳性表达率比较无显著性差异(P >0 .0 5 ) ;cyclinD 1阳性表达率与核分裂象数目有关,而与肿瘤直径及肿瘤坏死无关。结论 Ki- 67和cyclinD1蛋白是胃肠道间质瘤良恶性判断的有价值参考指标,结合胃肠道间质瘤形态学综合分析,更能准确客观地判断胃肠道间质瘤的良恶性。

Objective To investigate the significance of the expression of the Ki-67 and cyclin D1 protein in differentiating between the malignant and benign gastrointestinal stromal tumors(GISTs).Methods The expression of Ki-67 and cyclin D1 protein was detected by immunohistochemistry in 41 cases of GISTs.Results The Ki-67 labeling index in the benign,the borderline and the malignant GISTs was(8.5±3.9)%?(16.8±8.6)% and(21.8±8.3)%,respectively,showing a significant difference between the three groups(P<0.01).The Ki-67 labeling index was related to the tumor size,tumor necrosis and mitotic count.The positive rate of cyclin D1 protein in the benign,the borderline and the malignant GISTs was 16.7%,53.8% and 68.2% respectively.There was a significant difference in the cyclin D1 protein between the benign and the borderline GISTs,and between the benign and the malignant GISTs(P<0.05),but not between the borderline and the malignant GISTs(P<0.05).The positive rate of cyclin D1 protein was related to mitotic count,but not related to the tumor size and tumor necrosis.Conclusion The Ki-67 and cyclin D1 protein were valuable biomarkers in the differential diagnosis between the benign,the borderline and the malignant gastrointestinal stromal tumors.