[Relationship between expression of cyclin D1, Ki-67 and bcl-2 and biologic behavior in CD117-positive gastrointestinal stromal tumors].
OBJECTIVE
To investigate the clinicopathologic features of gastrointestinal stromal tumors (GISTs) and to identify reliable prognostic parameters.


METHODS
Fifty-nine GISTs were studied by immunostaining of CD117, CD34, SMA, desmin, S-100, bcl-2, and Ki-67. Histopathologic evaluations included tumor size, necrosis, histological growth patterns, mitotic activities and tumor lymphocytic infiltrate. The patients were clinically followed for 2 to 9 years. Univariate, multivariate and correlative statistical evaluations were used to analyze the data.


RESULTS
Among the 59 patients, 40 were alive and 15 died of their tumors at follow-up, the remaining 4 patients died of other causes. Pathological parameters that correlated with prognosis included tumor sizes of more than 5 cm, tumor tissue necrosis, mitotic cell count equal or higher than 5 per 50 high power field, Ki-67 labeling index (LI) equal or higher than 5% and intense bcl-2 immunostaining. Multivariate analysis showed that the mitotic count and Ki-67 LI were independent prognostic indicators. There was a correlation between mitotic count and Ki-67 LI.


CONCLUSIONS
Mitotic count and Ki-67 LI are the best predictors for a poor outcome of GIST after surgical treatment. Ki-67 immunostaining may substitute mitotic count as a useful prognostic parameter.
Department of Pathology, Second Affiliated Hospital, Jilin University, Changchun 130041, China. meisun855@sohu.com
Mei
M
Sun
Xing-yi
XY
Zhang
Hong-jie
HJ
Zou
Ya-xin
YX
Sun
Dong-fu
DF
Li
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D019938:Cyclin D1 / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism*; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism*
D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D019938:Cyclin D1; D019009:Proto-Oncogene Proteins c-kit