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Association of ki67 Index with Recurrence in Gastrointestinal Stromal Tumors

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Abstract

Purpose

Gastrointestinal stromal tumors (GIST) have the potential to recur and metastasize. Several prognostic schemes have been developed but none are precise enough and most times the pathologist faces a small biopsy where it is not possible to evaluate the mitotic count. Our aim was to determine the influence of ki67 index and other clinicopathologic characteristics in the recurrence of GIST.

Methods

Forty-three consecutive cases of GIST were studied. The cases presented with non-metastatic disease. We compared the clinicopathologic features of cases with recurrence against those with non-recurrence. The ki67 index was determined by square-millimeters.

Results

The median age was 55 years (IQR 45–63), the most frequent site of involvement was the stomach with 21 (48.8%) cases, and the median of tumor diameter was 10 cm (IQR 5.5–17.5). Twenty-six (60.5%) cases were spindle cell, 13 (30.2%) were mixed, and 4 (9.3%) were epithelioid. The median mitosis count for 50 high power fields was 4 (IQR 0–16), while per square millimeter it was 1 (IQR 0–5, range 0–32). The median of the ki67 proliferation index was 5% (IQR 1–20). During the period of study, 11 (25.6%) patients recurred. The only significant differences between patients with GIST with recurrence and without recurrence were the sex and tumor size.

Conclusion

We did not find an association of the ki67 index with recurrence. The factors associated with recurrence were a high tumor size (> 10 cm) and male sex.

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Abbreviations

GIST :

Gastrointestinal stromal tumor(s)

HPF :

High-power field

HR :

Hazard ratio

IQR :

Interquartile range

NIH :

National Institute of Health (USA)

ROC :

Receiver operating characteristic

USA :

United States of America

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Authors and Affiliations

Authors

Contributions

PSR and LSLS conceived of the study, and performed the interpretation of immunohistochemistry and pathological analysis. PSR, LSLS, and EAC retrieved clinical data. All authors participated in its design and coordination and helped to draft the manuscript. LSLS and RASH performed de statistical analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Leonardo S. Lino-Silva.

Ethics declarations

Ethics Approval and Consent to Participate

This study was conducted following the statements of Helsinki declaration and was approved by the Ethics in Investigation Board of our Institution with a waiver of informed consent (approval number Rev/70/17).

Consent for Publication

This work does not contain data that could identify any individual in any way, but a waiver of informed consent was obtained.

Competing Interests

The authors declare that they have no competing interests.

Declaration of Authorship

All authors meet the criteria for authorship as per the guidelines of the International Committee of Medical Journal Editors (ICMJE), all have participated at: (1) conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; (2) drafting the work or revising it critically for important intellectual content; (3) final approval of the version submitted; and (4) agreement to be accountable for all aspects of the work regarding the accuracy or integrity of the research.

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Segales-Rojas, P., Lino-Silva, L.S., Aguilar-Cruz, E. et al. Association of ki67 Index with Recurrence in Gastrointestinal Stromal Tumors. J Gastrointest Canc 49, 543–547 (2018). https://doi.org/10.1007/s12029-018-0150-z

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