Expression Of HIF-1? And Ki67 In Gastrointestinal Stromal Tumors And Its Effect On The Prognosis Of Gastrointestinal Stromal Tumor

Objective:To study the expression status and clinical significance of HIF-1? and Ki67 in gastrointestinal stromal tumors,and to explore the prognostic factors that may affect gastrointestinal stromal tumors,and provide new strategies for the diagnosis and treatment of gastrointestinal stromal tumors.Methods:A total of 215 cases of gastrointestinal stromal tumors obtained from surgery and pathologically confirmed at the First Hospital of Shanxi Medical University from January2011 to December 2018 were selected,and the expression status of HIF-1? and Ki67 was observed by immunohistochemistry.Using Chi-square test and Logistic regression to analyze the relationship between the expression of HIF-1? and Ki67 and the clinicopathological characteristics of gastrointestinal stromal tumors and the correlation between the expression of HIF-1? and Ki67.The clinical and pathological characteristics of overall survival were analyzed by multivariate Cox regression.Kaplan-Meier method and Log-Rank test were used,and survival curves were drawn for survival analysis.Results:Among 215 patients with gastrointestinal stromal tumors,99 were HIF-1?-negative expression cases(46.0%)and 116 were positive expression cases(54.0%).Univariate analysis showed that there was no statistically significant difference between HIF-1?expression and the sex,age,and primary site of patients with gastrointestinal stromal tumors(P> 0.05).There were significant correlations between clinicopathological features such as tumor diameter,tumor diameter,and NIH classification(P <0.05).Multivariate regression analysis also showed that there was no statistical significance between the expression of HIF-1? and the sex,primary site,and age of patients with gastrointestinal stromal tumors(P> 0.05).Tumor diameter(OR = 2.633;95% CI = 1.377 ~ 5.037),mitotic image(OR = 2.561,CI = 1.218 ~ 5.385),and NIH classification(OR = 2.306,CI = 1.123 ~ 4.734)were independent factors affecting HIF-1? expression(P <0.05),and had significant positive relationship.Among the 215 patients with gastrointestinal stromal tumors,108 cases of Ki67 low expression(50.2%)and 107 cases of Ki67 high expression(49.8%).Univariate analysis showed that the expression of Ki67 was not statistically significant with the sex,age,and primary site of patients with gastrointestinal stromal tumors(P> 0.05),but with mitotic images and tumors The clinicopathological characteristics such as diameter and NIH classification were significantly correlated(P <0.05).Multivariate regression analysis still showed no significant difference between Ki67 expression and gender,primary site,and age of patients with gastrointestinal stromal tumors(P> 0.05).Tumor diameter(OR = 2.926;95% CI = 1.478 ~ 5.789),mitotic image(OR = 2.194,CI = 1.017 ~ 4.734),and NIH classification(OR = 4.466,CI = 2.098 ~9.506)were independent factors affecting Ki67 expression(P <0.05),and had significant positive correlation.In cases with negative HIF-1? expression,Ki67 was highly expressed in 29.3%(29/99)of patients.In cases with positive HIF-1? expression,Ki67 was highly expressed in 67.2%(78/116)of patients.There was a significant correlation between the expression of HIF-1? and the expression level of Ki67(P <0.05,and the column connection number C = 0.354).Of the 215 patients,42 were lost to follow-up,28 died,and the 5-year survival rate was 76.2%.Kaplan-Meier survival analysis was used to analyze the relationship between HIF-1? and Ki67 expression levels and overall survival(OS).Log-Rank test was used tocompare the survival rates of different expression levels of HIF-1? and Ki67,and the differences were statistically significant(P <0.05).Survival curve results showed that patients with HIF-1?-negative patients had better prognosis than patients with HIF-1?-positive patients,and patients with lower Ki67 expression had better prognosis.Multivariate Cox regression analysis showed that tumor diameter,mitotic image,HIF expression level,and Ki67 expression level were all independent factors affecting the overall survival(OS)of patients with gastrointestinal stromal tumors(P <0.05).Conclusion:The expression of HIF-1? in gastrointestinal stromal tumor has a significant positive correlation with the expression of Ki67,which may be involved in the progression of gastrointestinal stromal tumor disease and play an important role in the occurrence and development of gastrointestinal stromal tumor disease.HIF-1? combined with Ki67 can be used to evaluate the prognosis of patients with gastrointestinal stromal tumor,providing new ideas for the diagnosis and treatment of gastrointestinal stromal tumor.