胃肠道间质瘤中Ki-67的表达水平及其与危险度分级和预后的关系

Expression Level of Ki-67 in Gastrointestinal Stromal Tumors and Its Relationship with Risk Classification and Prognosis

目的探讨胃肠道间质瘤(GIST)中Ki-67的表达水平及其与危险度分级和预后的关系。方法回顾性分析郑州大学第一附属医院2011年8月至2018年8月收治的470例接受手术切除的原发GIST患者的临床病理资料,术后对患者进行随访,分析Ki-67的表达水平及其与GIST的危险度分级和预后的关系。结果Ki-67高表达组和Ki-67低表达组肿瘤直径、核分裂象、囊性变、CT强化、手术方式及危险度分级比较,差异有统计学意义(P<0.05)。Spearman秩相关结果显示,肿瘤直径、核分裂象、有无囊性变、手术方式、Ki-67增殖指数、肿瘤原发部位与GIST危险度分级相关(P<0.05)。多因素logistic回归分析结果显示,Ki-67增殖指数、CT是否强化是GIST危险度分级的影响因素(P<0.05)。高危险度GIST患者Ki-67高表达组和低表达组术后无进展生存情况比较,差异有统计学意义(P<0.05)。结论Ki-67表达水平可作为判断GIST危险度分级及预测预后的重要参考指标。

Objective To explore the expression level of Ki-67 in gastrointestinal stromal tumors(GIST)and its relationship with risk classification and prognosis.Methods The clinicopathological data of 470 cases of primary GIST surgically resected in the First Affiliated Hospital of Zhengzhou University from August 2011 to August 2018 were retrospectively analyzed.The postoperative patients were followed up to analyze the expression level of Ki-67 and its relationship with risk classification and prognosis of GIST.Results There were statistical differences in tumor diameter,mitotic figure,cystic change,CT enhancement,operation method and risk classification between Ki-67 high expression group and Ki-67 low expression group(P<0.05).Spearman rank correlation showed tumor diameter,mitotic figure,cystic change or not,operation method,Ki-67 proliferation index,primary tumor site were correlated with risk classification of GIST(P<0.05).Multivariate logistic regression analysis showed that Ki-67 proliferation index and CT enhancement or not were the influencing factors of risk classification of GIST(P<0.05).Survival analysis was performed on the patients with GIST with high risk,and there was a statistical difference in the postoperative progression-free survival between Ki-67 high expression group and Ki-67 low expression group(P<0.05).Conclusion The expression level of Ki-67 can be used as an important reference index to judge the risk classification and predict the prognosis of GIST.