Prognostic significance of PTEN,Ki-67 and CD44s expression patterns in gastrointestinal stromal tumors

• Published in: World journal of gastroenterology : WJG 2012-04, Vol.18 (14), p.1664-1671
• Main Authors: Liang, Yu-Mei, Li, Xiang-Hong, Li, Wen-Mei, Lu, You-Yong
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor - metabolism; Brief; Disease-Free Survival; Female; Follow-Up Studies; Gastrointestinal Neoplasms - diagnosis; Gastrointestinal Neoplasms - metabolism; Gastrointestinal Stromal Tumors - diagnosis; Gastrointestinal Stromal Tumors - metabolism; Humans; Hyaluronan Receptors - metabolism; Immunohistochemistry; Intestinal Neoplasms - diagnosis; Intestinal Neoplasms - metabolism; Ki-67 Antigen - metabolism; Male; Matrix Metalloproteinase 9 - metabolism; Middle Aged; Prognosis; PTEN Phosphohydrolase - metabolism; PTEN基因; Risk Assessment; Stomach Neoplasms - diagnosis; Stomach Neoplasms - metabolism; TIMP-1; Tissue Inhibitor of Metalloproteinase-1 - metabolism; 决策支持系统; 美国国立卫生研究院; 胃肠道; 表达模式; 间质; 预后
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i14.1664

AIM：To develop a prognostic approach for gastrointestinal stromal tumors（GISTs） using a cluster of indicators and follow-up information.METHODS：One hundred and four GISTs that had not been subjected to targeted therapies were collected and classified by NIH risk assessment and anatomic location.By immunohistochemistry,the expressions of PTEN,Ki-67,CD44s matrix metalloproteinase（MMP）-9 and TIMP-1 were detected on tissue microarray.Univariate and multimarker survival analyses were performed and then a COX hazard proportion model was constructed to evaluate a cluster of predictors of GIST.RESULTS：Our data showed small intestinal GIST are more aggressive than gastric GIST.The NIH risk assessment correlated with disease-free survival foreither gastric GIST or small intestinal GIST.Immunohistochemical analysis revealed that Ki-67 labeling indexes（LIs） 5% predicted higher disease-specific survival（DSS） in gastric and small intestinal GIST.CD44s positivity and PTEN LIs ≥ 50% correlated with higher DSS in gastric GIST.MMP-9 and TIMP-1 had no correlation with survival.Multimarker analysis revealed that the expression pattern of PTEN LIs ≥ 50% combined with Ki-67 LIs 5% and CD44s positivity reliably predicted favorable outcomes for gastric GIST（P = 0.009）,as did the combination of PTEN LIs ≥ 50% and Ki-67 LIs 5% for small intestinal GIST（P = 0.011）.Authors also found that high NIH risk grade was correlated with DSS in patients with gastric GIST and disease-free survival in patients with small intestinal GIST.CONCLUSION：PTEN LIs ≥ 50%,Ki-67 LIs 5% and CD44s positivity provides an accurate,favorable prognosis for gastric GIST.PTEN LIs ≥ 50% and Ki-67 LIs 5% does the same for small intestinal GIST.Ki-67 LIs enhances the NIH assessment.