KIT 11外显子突变合并Ki-67指数对评估胃肠道间质瘤预后的价值  

The value of KIT exon 11 mutations combined with Ki-67 index in evaluating the prognosis of gastrointestinal stromal tumour

作　　者：张朕 符洋[1] Zhang Zhen;Fu Yang(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院胃肠外科,郑州450052

出　　处：《中华普通外科杂志》2023年第11期826-830,共5页Chinese Journal of General Surgery

基　　金：河南省高等学校青年骨干教师培养计划(2019GGJS024)。

摘　　要：目的探讨KIT 11外显子突变合并Ki-67指数对评估胃肠道间质瘤预后的价值。方法回顾性分析2011年1月至2020年12月在郑州大学第一附属医院确诊为胃肠道间质瘤444例患者的临床病理资料,采用Kaplan-Meier法绘制生存曲线并用Log-Rank检验法分析生存曲线的差异,COX回归分析影响胃肠道间质瘤预后的因素。绘制ROC曲线对比美国国立卫生研究院(NIH)危险度分级和新构建的合并KIT 11外显子突变和Ki-67指数的预后风险模型。结果肿瘤位置、肿瘤直径、危险度分级、核分裂象、Dog-1与KIT 11外显子突变合并Ki-67指数均有关(均P<0.05)。生存分析显示,KIT 11缺失突变合并Ki-67高表达患者的无复发生存时间更短。多因素COX回归分析显示,KIT 11缺失突变合并Ki-67高表达和高核分裂象是影响胃肠道间质瘤患者预后的独立危险因素(均P<0.05)。ROC曲线显示,NIH危险度分级的AUC值(0.713)小于新的预后风险预测模型的AUC值(0.767)。结论KIT 11缺失突变合并Ki-67高表达的胃肠道间质瘤患者预后更差。KIT 11外显子突变合并Ki-67指数可作为NIH危险度分级预测胃肠道间质瘤患者预后的有效补充。Objective To investigate the value of KIT exon 11 mutations combined with Ki-67 index in evaluating the prognosis of gastrointestinal stromal tumor.Methods The correlation between KIT exon 11 mutation type combined with Ki-67 proliferation index and clinicopathological features in 444 primary gastrointestinal stromal tumors was analyzed.Using Kaplan-Meier method to plot survival curves and Log-Rank test to analyze the differences in survival curves,COX regression risk model was used to analyze the factors affecting the prognosis of gastrointestinal stromal tumors.ROC curves were plotted comparing NIH risk classification and a newly constructed prognostic risk model combining KIT 11 mutations and Ki-67 mitotic count.Results There was a correlation between KIT 11 mutation combined with Ki-67 expression and tumor location,tumor diameter,risk classification,mitotic count,and Dog-1(all P<0.05).Survival analysis showed that patients in the KIT 11 deletion mutation combined with Ki-67 high expression had shorter relapse-free survival times(RFS).Multivariate COX risk proportional regression model analysis showed that KIT 11 deletion mutation combined with Ki-67 high expression and high mitotic count were independent risk factors affecting the prognosis of gastrointestinal stromal tumor(all P<0.05).The ROC curve showed that the AUC value of NIH risk classification(0.713)was smaller than that of the newly prognostic risk model(0.767).Conclusions Patients of KIT 11 deletion mutations combined with high Ki-67 expression had a worse prognosis.KIT exon 11 mutations combined with high Ki-67 proliferation index can be a useful complement to the NIH classification for predicting GIST prognosis.

关 键 词：胃肠道间质肿瘤 外显子 预后 KI-67指数 

分 类 号：R735[医药卫生—肿瘤]