胃肠道间质瘤中Ki-67、VEGF的表达及其意义

Expression of Ki-67 and VEGF and their clinicopathological significance in gastrointestinal stromal tumors

目的探讨Ki-67及肿瘤转移密切相关的血管内皮细胞生长因子(VEGF)与胃肠道间质瘤(gastrointestinal stromaltumors,GIST)生物学行为分级的关系。方法选取70例GIST蜡块构建组织芯片,采用免疫组化法联合检测Ki-67及VEGF,并结合病理形态学及生物学行为分级进行分析。结果①Ki-67阳性17例(阳性率24·3%),其中,极低度侵袭危险性(VLR)0/6例,低度侵袭(LR)危险性1/16例,中度侵袭危险性(IR)3/21例,高度侵袭危险性(HR)13/27例,HR组Ki-67表达与IR、LR及VLR组之间差异有显著性(χ2=13·61,P<0·01);生物学行为分级与Ki-67表达呈正相关(r=0·435,P<0·01)。②VEGF阳性45例(阳性率64·3%),其中,VLR组(0/6例)的阳性表达率低于HR(22/27例)、LR(10/16例)及IR组(13/21例)(χ2=8·34,P<0·01)。梭形细胞型、混合细胞型和上皮样细胞型GIST的VEGF阳性率分别为51·2%(21/41)、82·4%(14/17)及83·3%(10/12),上皮样细胞型和混合细胞型的VEGF表达较梭形细胞型差异有显著性(χ2=7·40,P<0·01);VEGF的表达不但与生物学行为分级呈正相关(r=0·332,P<0·05),而且与病理形态学分型呈正相关(r=0·263,P<0·05)。结论Ki-67和VEGF的表达与GIST生物学行为关系密切,可作为GIST生物学行为的潜在评价指标。

Purple To explore the relationship between the expression of Ki-67 and vascular endothelial growth factor （VEGF） and biological behavior of gastrointestinal stromal tumors（GIST）. Methods Two tissue microarrays（TMAs） contained 10×10 tissue cores were constructed, including 70 cases of GIST. These tissue sections were studied immunohistochemically for the expression of Ki-67 and VEGF, and their relations with histopathology and biological behavior were analyzed statistically. Results ① Out of 70 cases, 17 cases were positive for Ki-67（24. 3% ） , of which the very low-risk, low-risk, intermediate risk and high-risk groups were O, 1, 3 and 13 cases, respectively. In the 17 cases of Ki-67-positive tumors, high-risk group expressed Ki-67 more frequently（48. 1% ） than very low-risk（O case） , low-risk（6.25% ） and intermediate risk one（ 14, 3% ） （ X^2 = 13.61, P 〈0. 01 ）. There was a significant correlation between the expression of Ki-67 and biological behavior（ r = 0. 435, P 〈 0. 01 ）. ② 45 cases exhibited VEGF expression（64. 3% ） , of which the very low-risk, low-risk, intermediate risk and high-risk groups were 0, 10, 13 and 22 cases, respectively. In the 45 cases of VEGF-positive tumors, low-risk, intermediate risk and high-risk group expressed VEGF more frequently （70. 0% ） than the very low-risk （0 case） （ X^2 = 8. 34 ,P 〈0. O1 ）. Spindle cell variant expressed VEGF less frequently （51.2%） than mixed cell variant（82. 4% ） and epithelioid cell variant（ 83.3% ） （X^2 = 7.40,P 〈0. O1 ）. There were not only significant relations between the expression of VEGF and the biological behavior（ r = 0. 332, P 〈 0. 05 ） , but also between the expression of VEGF and pathological variants （ r = 0. 263, P 〈 0. 05 ）. Conclusions Ki-67 and VEGF are closely related with the biological behavior of GIST, and they might be potential markers for evaluation of GIST behavior.