Role of Ki-67 as a prognostic factor in gastrointestinal stromal tumors

Belev, Borislav; Brčić, Iva; Prejac, Juraj; Golubić, Zrna Antunac; Vrbanec, Damir; Božikov, Jadranka; Alerić, Ivan; Boban, Marko; Razumović, Jasminka Jakić

doi:10.3748/wjg.v19.i4.523

Cited by 52 publications

(38 citation statements)

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“…In this series, the gender distribution was different from the ones in the literature, there was a predominance of females (59.5%), while literature indicates a homogeneous distribution or a slight predominance of males 11,[16][17][18] and, by contrast, the average age of patients (57 years) was similar to that found in other series 2,17 . In this sample, the preferred location in the stomach, followed by small intestine, large intestine and esophagus was also observed by other authors 2,11 .…”

Section: Discussion Discussion Discussion Discussion Discussioncontrasting

confidence: 51%

“…Independently of this demonstration, some data needs to be emphasized, because the average size of the tumors of patients with worse prognosis was higher than in patients with good prognosis. Also, of the 21 tumors with recurrence, 17 were larger than 5cm, from which it can be inferred that size is an important prognostic criteria.The mitotic index (MI) of more than 5 per 50 CGA was also a variable associated with prognosis, as observed by other authors 7,11,15,17,18,20 . The evaluation of this variable is present in the two main risk levels 7,11 used to characterize GIST prognosis.…”

supporting

confidence: 54%

“…The mitotic index (MI) of more than 5 per 50 CGA was also a variable associated with prognosis, as observed by other authors 7,11,15,17,18,20 . The evaluation of this variable is present in the two main risk levels 7,11 used to characterize GIST prognosis.…”

supporting

confidence: 54%

“…Nonetheless, neoplasms with muscle differentiation showed greater disease-free intervals 17 . However, the authors point out that these results need to be evaluated carefully, since the tumors with muscle differentiation had a less aggressive biological course.…”

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confidence: 99%

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Comparative study of the different degrees of risk of gastrointestinal stromal tumor

Oliveira

Filho

Iglesias

et al. 2015

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTObjective Objective Objective Objective Objective: To evaluate the applicability of the main categories of risk and morphological factors in the prognosis of gastrointestinal stromal tumors. MethodsMethods Methods Methods Methods: we retrospectively studied fifty-four cases of GIST, assessing the main prognostic factors of this neoplasis: risk levels, topography, size, mitotic index, necrosis, histological subtype and immunophenotype. We also verified their association and the reduction of overall survival. Results Results ResultsResults Results: Univariate analysis showed that tumors with mitoses number greater than 5 per 50CGA (high-power fields), the presence of necrosis and a high risk for both the systems proposed by Fletcher and Miettinen had a significant association with reduced survival (p = 0.00001, 0.0056, 0.03 and 0.009, respectively). The remaining analyzed factors (size, histological subtype, topography and immunophenotype) had no such association. Multivariate analysis (Jacard index) showed that the Miettinen degree of risk was the one that best correlated with prognosis. Conclusion Conclusion Conclusion Conclusion Conclusion: the risk criteria of Fletcher and Miettinen are important in assessing the prognosis of patients with gastrointestinal stromal tumors, especially the latter, which adds to the mitotic index and the presence of tumor necrosis. G astrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasms of the gastrointestinal tract 1 , their incidence being estimated at 14 to 20 cases per million population 2 ; they are more frequent in male patients older than 50 years old 3 . The pathogenesis is related to mutational changes in two tyrosine kinase receptors: KIT and PDGFR-alpha (plateletderived growth factor receptor alpha) on the surface of the interstitial cells of Cajal, the former being the most common (85% of cases) 4,5 . Gastrointestinal stromal tumors can develop in any topography, from the esophagus to the rectum. However, they are more common in the stomach (50% to 60%), followed by small intestine (20% to 30%), colon (10%), rectum or esophagus (5%) 6 . Macroscopically, the tumor lesions often have a nodular form, transmural involvement and submucosal growth, with ulceration of the mucosa or not. In light microscopy, histology reveals three types: the most common spindle (70%), epidermoid (20%) and the mixed type (10%), when there is combination of epithelioid and spindle ones 7 . Key wordsThe diagnosis of stromal neoplasms is based on immunohistochemical study with CD117 marker, expressed in most such neoplasias 1 . Noteworthy are also other markers: DOG 1, nestin, theta protein kinase C and carbonic anhydrase II 8 . The differential diagnosis includes: desmoid tumor, inflammatory myofibroblastomas, leiomyoma, inflammatory fibroid polyp, neuroma, neurossarcoma, sarcomatoid mesothelioma and metastatic melanoma 7,9,10 GIST prognosis is still matter of discussion. Currently there are different classifications 7,[11][12...

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Section: Discussion Discussion Discussion Discussion Discussioncontrasting

confidence: 51%

supporting

confidence: 54%

supporting

confidence: 54%

mentioning

confidence: 99%

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Comparative study of the different degrees of risk of gastrointestinal stromal tumor

Oliveira

Filho

Iglesias

et al. 2015

Rev. Col. Bras. Cir.

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“…Объективными признаками неблагопри-ятного прогноза на сегодняшний день также признано повышение индекса пролиферации по экспрессии Ki-67 (более 10% ядер, экспрес-сирующих Ki-67), утрата опухолевыми клетка-ми экспрессии маркеров нейрогенной и глад-комышечной дифференцировок [30].…”

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