[Roles of risk assessment and Ki-67 index in judging prognostic of gastrointestinal stromal tumors].
OBJECTIVE
To investigate the roles of risk assessment and Ki-67 index in judging prognostic of gastrointestinal stromal tumors (GISTs).


METHODS
The clinical data of 102 patients of GIST, 60 with gastric stromal tumor and 42 with small intestinal stromal tumor were collected. The relations of disease free survival rate and disease specific overall survival rate to Ki-67 index and risk assessment were analyzed.


RESULTS
Risk assessment showed that 2 cases were at very low risk, 14 at low risk, 16 at intermediate risk, and 28 at high risk. As classified by the Ki-67 index system, 13 cases were in the group of Ki-67 index > or =5%, and the other 47 cases were in the group of Ki-67 index <5%. The patients with high risk or Ki-67 index > or =5% had significantly lower disease-free survival rates (Pki-67 = 0.001, P risk assessment = 0.044) and disease specific overall survival rates (Pki-67 = 0.001, P risk assessment = 0.007). The high-risk patients had significantly lower survival rate than the patients of other grades (P disease-free = 0.044, P over all = 0.012). In the 42 patients with small intestinal stromal tumor 9 were at low risk, 11 at intermediate risk, and 22 at high risk;and there were 12 cases with Ki-67 index > or =5% and 30 cases with Ki-67 index <5%. Risk assessment had no relationship with disease specific overall survival rate. The overall survival rate of the intestinal stromal tumor patients with the Ki-67 index > or =5% was significantly lower than that of those with the K-67 index <5% (P = 0.039), however, Ki-67 index was not related to disease free survival rate. Four of the gastric stromal tumor patients at low and intermediate risk and with Ki-67 index > or =5% suffered recurrence or metastasis; and 2 similar cases were found in the small intestinal stromal tumor cases.


CONCLUSIONS
Risk assessment and Ki-67 index are good prognostic indicators for gastric stromal tumors. In small intestinal stromal tumors, risk assessment is only related to disease free survival rate, and Ki-67 index is related to disease specific overall survival rate. In the GIST patients at low and intermediate risk, Ki-67 can be a good complimentary indicator to predict the recurrence or metastasis.
Liang
Yu-mei
YM
Department of Pathology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
Li
Xiang-hong
XH
Chen
Wei
W