title: Prognostic value of Ki67 index in gastrointestinal stromal tumors.
abstract: BACKGROUND
  Ki67 index is one of the most important immunocytochemical markers of proliferation in tumors, but the criterion of Ki67 index in GISTs was not well-defined yet. Our study aims to fully evaluate the prognostic value of Ki67 index in GIST patients and efficiency of imatinib adjuvant therapy.
  
  
  METHODS
  Clinicopathological data were confirmed by pathological diagnosis and clinical recorders. Recurrence-free survivals (RFS) were evaluated in 418 GIST patients (370 cases only taken the surgery and 48 high-risks taken imatinib adjuvant therapy after R0 resection).
  
  
  RESULTS
  Two cutoff levels of Ki67 index (>5 and >8%) were established in our study through statistical analysis. Ki67 index (≤5, 6-8 and >8%) is an independent prognostic factor for RFS of GIST patients. Ki67 index>8% can precisely sub-divide high-risk GISTs effectively with different outcomes, and high-risk patients with Ki67 index>8% showed a poorer prognosis even with imatinib adjuvant therapy.
  
  
  CONCLUSIONS
  Ki67 index is an effective complementation of modified NIH criteria in predicting the prognosis of GISTs, and Ki67 index>8% may act as an unfavorable factor for imatinib adjuvant therapy.
authors: Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors: Wen-Yi
authors: WY
authors: Zhao
authors: Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors: Jia
authors: J
authors: Xu
authors: Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors: Ming
authors: M
authors: Wang
authors: Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors: Zi-Zhen
authors: ZZ
authors: Zhang
authors: Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors: Lin
authors: L
authors: Tu
authors: Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors: Chao-Jie
authors: CJ
authors: Wang
authors: Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors: Tian-Long
authors: TL
authors: Lin
authors: Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors: Yan-Yin
authors: YY
authors: Shen
authors: Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors: Qiang
authors: Q
authors: Liu
authors: Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors: Hui
authors: H
authors: Cao
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides / Q000627:therapeutic use; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000737:chemistry* / Q000401:mortality / Q000628:therapy; D006801:Humans; D000068877:Imatinib Mesylate; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D010879:Piperazines / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D012307:Risk Factors; D013997:Time Factors; D046888:Tissue Array Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D019394:Ki-67 Antigen; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate
keywords: Gastrointestinal stromal tumor; Ki67; prognosis; targeted therapy