胃肠道间质瘤中Ki一67、cyclinD1和bcl-2的表达与危险度及预后的关系

Expression of Ki-67, cyclinD1 and bcl-2 and its correlation with risk rank and progression of gastrointesfinal stromal tumors

目的探讨胃肠道间质瘤（GIST）中Ki-67增殖指数（u）、cyclinDl和bcl-2的表达与危险度及预后的关系。方法对76例确诊的GIST应用免疫组化SP法检测Ki--67、cyclinD1和bcl-2的表达，分析与危险度和预后的关系。结果危险度极低、低、中和高度分别为10、23、18和25例；随访61例，其中42例健在，12例死于GIST，7例死于其他原因。Ki-67LI〉5％与核分裂象〉5／50HPF、肿瘤直径〉5cm及危险度中高有关（P〈0．05）；cyclinD1和bcl-2的阳性表达与核分裂象、肿瘤大小无关而与中高危组相关（P〈0．05）。结论Ki-67、cyclinD1和bcl-2在GIST中、高危险度组高表达，可作为预测危险度和预后有用的指标，Ki-67LI可作为独立指标。

Objective To study the expression of Ki-67 labeling index（H） ,cyclin D1 and hcl-2 and their relationship with risk rank and progression of gastrointcstinal stromal tumors（GISTs）. Methods The expression of Ki-67 ,Cyclin D1 and bcl-2 was detected by S-P method in 76 cases of GISTS and the relationship of the expression and risk rank and progression was analyzed. Results The number of patients at extremely low, low, moderate, and high risk was 10,23,18 and 25.61 patients were at follow-up, Among them 42 were alive and 12 died of their tumors and the remaining 7 patients died of other causes. Ki-67 LI 35% correlated with tumor sizes of 〉 5 cm, tumor mitotic cell count 〉15/50 HPF, and cyclinD1 and bcl-2 had higher expression in higher （moderate and high） risk cases（P 〈 0. 05 ）. Conclusion Ki-67, cyclin D1 and bcl-2 are highly expressed in higher risk GISTs cases, and can be used for assessing the risk of patients. Ki-67 LI might be an independent risk indicator for GISTs and a predictor for pronosis.