Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 28, 2012; 18(20): 2569-2575
Published online May 28, 2012. doi: 10.3748/wjg.v18.i20.2569
Evaluation of malignancy using Ki-67, p53, EGFR and COX-2 expressions in gastrointestinal stromal tumors
Jing Jiang, Mei-Shan Jin, Jian Suo, Yin-Ping Wang, Liang He, Xue-Yuan Cao
Jing Jiang, Division of Clinical Epidemiology, Jilin University First Hospital, Changchun 130021, Jilin Province, China
Mei-Shan Jin, Yin-Ping Wang, Division of Pathology, Jilin University First Hospital, Changchun 130021, Jilin Province, China
Jian Suo, Liang He, Xue-Yuan Cao, Department of Gastrointestinal Surgery, Jilin University First Hospital, Changchun 130021, Jilin Province, China
Author contributions: Jiang J and Cao XY designed the study and carried out most of the experiments; Jin MS and Cao XY collected patients’ clinical information; Jin MS and Wang YP analyzed pathological data; Jiang J performed statistical analysis and wrote the manuscript; Suo J and He L provided valuable suggestions in the preparation of the manuscript.
Correspondence to: Xue-Yuan Cao, MD, PhD, Department of Gastrointestinal Surgery, Jilin University First Hospital, 71 Xinmin Street, Changchun 130021, Jilin Province, China. ccmzc32jdyycao@yahoo.com.cn
Telephone: +86-431-887832737 Fax: +86-431-887832889
Received: July 8, 2011
Revised: September 27, 2011
Accepted: October 27, 2011
Published online: May 28, 2012
Abstract

AIM: To investigate the role of expressions of Ki-67, p53, epidermal growth factor receptor (EGFR) and cyclooxygenase-2 (COX-2) in gastrointestinal stromal tumor (GIST) grading and prognosis.

METHODS: Tumor tissue was collected retrospectively from 96 patients with GIST. Antibodies against Ki-67, p53, EGFR and COX-2 were used for immunohistochemical staining. Tumor grading was designated according to a consensus system and the staining was quantified in 3 categories for each antibody in the statistical analysis.

RESULTS: The Ki-67 expression in GISTs was significantly associated with the size of the tumors, mitotic rate and the risk of malignancy (χ2 = 15.51, P = 0.02; χ2 = 22.27, P < 0.001; χ2 = 20.05; P < 0.001). The p53 expression was also significantly correlated with mitotic rate and the risk of malignancy (χ2 = 9.92, P = 0.04; χ2 = 9.97; P = 0.04). Over-expression of Ki-67 was strongly correlated with poor survival (χ2 = 10.44, P = 0.006), but no correlation was found between the expression of p53, EGFR or COX-2 and survival. Multivariate analysis further demonstrated that Ki-67 expression (relative risk = 15.78, 95% CI: 4.25-59.37) could be used as an independent prognostic value for GIST patients. Adjuvant imatinib therapy could improve clinical outcomes in the patients with high risk and intermediate risk of recurrence after complete tumor resections (median survival time: 52 mo vs 37 mo, χ2 = 7.618, P = 0.006).

CONCLUSION: Our results indicated that the expression of Ki-67 could be used as an independent prognostic factor for GIST patients.

Keywords: Gastrointestinal stromal tumor; Prognosis; Ki-67 alteration; p53; Epidermal growth factor receptor