Prognostic Value Of Ki67 Index And Gastrointestinal Bleeding In Gastrointestinal Stromal Tumors

Objective:Many researches showed that Ki67 index are significantly associated with the cell proliferations of varied tumors,furthermore,gastrointestinal(GI)bleeding is one of the most common symptoms of gastrointestinal stromal tumors(GIST)patients.Nowadays,with the constant and excellent developments of risk stratification system,modified National Institutes of Health risk stratification system is the most popular method to determine the treatment plans and dose of Imatinib of GIST patients.This research aims to evaluate the prognostic value of clinicopathological parameters such as mitotic index,Ki67 index and GI bleeding.Additionally,I desire to improve modern stratification systems depending what we have discussed in this research.Method: All of the 36 primary GIST patients received R0 resection and their clinicopathological data are collected from pathological diagnostic reports and clinical information system of ShengJing Hospital.Results:After the receiver operator characteristic test,I decided the most powerful cut-off point of Ki67 index is 3.5% with sensitivity of 0.692,specificity of 0.696 and p=0.015.Univariate survival test demonstrates that tumor size,primary location,Ki67 index,mitotic index,risk stratification and GI bleeding are significantly involved with the worse prognostic event like relapse.Variate analyze shows that GI bleeding is an independent predictable factor of GIST’s recurrence with a hazard ratio of 10.527 and p=0.038.Conclusion:Ki67 index is significantly associated with the worse prognosis and risk stratification.Besides GI bleeding is an independent predicable factor of bad prognosis.Apparently,depending what we have discussed above,GI bleeding may be helpful to promote the accuracy of today’s risk stratification systems and bring advantages to GIST patients.