nm23-H1——胃肠道间质瘤新的预后标记物

The role of nm23-H1 as a novel predictor for prognosis of gastrointestinal stromal tumors

目的探讨nm23-H1在胃肠道间质瘤(GISTs)中的表达情况,为GISTs的预后判断提供新的病理学依据。方法应用免疫组织化学EnVision法检测nm23-H1和Ki-67在52例GISTs(转移组17例,非转移组35例)中的表达情况,对二者与Fletcher分级、临床指标及与GISTs转移的关系进行统计学分析。结果nm23-H1和Ki-67表达与Fletcher分级之间均有显著相关性(P<0.01),而与GISTs肿瘤部位及细胞类型均未见相关(P>0.05)。转移组与非转移组比较:nm23-H1阳性细胞数<50%的病例数与>50%的二组(50%～75%,>75%)之间分别比较,差异均有统计学意义(P<0.05);Ki-67增殖指数<5%的病例数与>5%的两组(5%～10%,>10%)之间比较差异有统计学意义(P<0.05)。对nm23-H1和Ki-67阳性表达例数进行统计比较,二者间有正相关关系(P<0.05)。结论nm23-H1可能是预测GISTs有无转移的有效标记物;联合检测nm23-H1和Ki-67表达,估计GISTs预后可能是一项有用指标。

Objective To investigate the expression of nm23-H1 in gastrointestinal stromal tumors （GISTs） and to provide a new pathology evidence for prognostic judgment of GISTs. Methods The EnVision immunohistochemical method was used to detect the expressions of nm23-H1 and Ki-67 in 52 cases of GISTs （including 17 cases with metastasis and 35 without metastasis）. The correlation of these with Fletcher grading, clinical data and metastasis of GISTs were analyzed statistically. Results Expressions of nm23-H1 and Ki-67 were significantly correlated with Fletcher grading of GISTs （P〈0.01） but not with the tumor sites and cell types （P〉0.05）. In both metastasis and non- metastasis groups： the number of cases with 〈50% nm23-H1 positive cell counts was statistically different from those with nm23-H1 positive cell counts above 50% （50%-75%, 〉75%, P〈0.05）, as was the number of cases with 〈5% proliferation index of Ki-67 from those with 〉5% Ki-67 proliferation index （5%-10%, 〉10%, P〈0.05）. A positive correlation was also shown between nm23-H1 and Ki-67 expressions （P〈0.05）. Conclusion The expression of nm23 may be a useful tumor marker to predict metastasis in GISTs. Combined detection of nm23-H1 and Ki-67 expressions may show promises for prognostic evaluation in GISTs.