title: Midkine as a prognostic marker for gastrointestinal stromal tumors.
abstract: 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.
authors.affiliation: Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. jkaifi@uke.uni-hamburg.de
authors.forename: Jussuf T
authors.initials: JT
authors.lastname: Kaifi
authors.forename: Henning C
authors.initials: HC
authors.lastname: Fiegel
authors.forename: Svanheidur L
authors.initials: SL
authors.lastname: Rafnsdottir
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Aridome
authors.forename: Paulus G
authors.initials: PG
authors.lastname: Schurr
authors.forename: Uta
authors.initials: U
authors.lastname: Reichelt
authors.forename: Robin
authors.initials: R
authors.lastname: Wachowiak
authors.forename: Helge
authors.initials: H
authors.lastname: Kleinhans
authors.forename: Emre F
authors.initials: EF
authors.lastname: Yekebas
authors.forename: Oliver
authors.initials: O
authors.lastname: Mann
authors.forename: Keiko
authors.initials: K
authors.lastname: Ichihara-Tanaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Muramatsu
authors.forename: Dietrich
authors.initials: D
authors.lastname: Kluth
authors.forename: Tim
authors.initials: T
authors.lastname: Strate
authors.forename: Jakob R
authors.initials: JR
authors.lastname: Izbicki
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D016207:Cytokines; D000078792:Midkine