Midkine as a prognostic marker for gastrointestinal stromal tumors.
OBJECTIVE
Midkine (MK), a heparin-binding growth factor, has an important role in cancer progression. The outcome of patients with gastrointestinal stromal tumors (GISTs) is correlated with tumor size and mitotic count. The aim of this study was to determine MK expression in GISTs.


METHODS
Midkine was detected in 31 (55%) of 57 surgically resected GISTs by immunohistochemistry with a rabbit antibody against MK and peroxidase method.


RESULTS
A significant worse outcome of MK-positive patients was found (P < 0.05; log rank test). Multivariate Cox regression analysis showed an independent prognostic impact (relative risk for overall survival 3.64; P < 0.05). Interestingly, MK expression was significantly associated with mitotic rate (P < 0.05; Chi-squared test), but not with tumor size (P = 0.97).


CONCLUSIONS
Taken together, MK is a prognostic marker for GIST patients. MK might also be a useful peripheral tumor marker since it can be detected in peripheral serum. Future studies should involve higher GIST patient numbers including tumor and serum samples for detection of MK.
Kaifi
Jussuf T
JT
Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. jkaifi@uke.uni-hamburg.de
Fiegel
Henning C
HC
Rafnsdottir
Svanheidur L
SL
Aridome
Kuniaki
K
Schurr
Paulus G
PG
Reichelt
Uta
U
Wachowiak
Robin
R
Kleinhans
Helge
H
Yekebas
Emre F
EF
Mann
Oliver
O
Ichihara-Tanaka
Keiko
K
Muramatsu
Takashi
T
Kluth
Dietrich
D
Strate
Tim
T
Izbicki
Jakob R
JR
D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D000078792:Midkine; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D014408:Biomarkers, Tumor; D016207:Cytokines; D000078792:Midkine