Prognostic significance of standardized AgNOR analysis and Ki-67 immunostaining in gastrointestinal stromal tumors

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Abstract

AbstractOBJECTIVE: To evaluate the prognostic utility of argyrophilic nucleolar organizer region (AgNOR) protein parameters and Ki-67-immunostained growth fraction (Ki-67 labelling index) and to correlate AgNORs with Ki-67 LI and the main clinicopathologic parameters in gastrointestinal stromal tumors (GISTs). STUDY DESIGN: On 55 patients with surgically excised GISTs, visualization and quantification of AgNORs were performed as specified in the guidelines of the Committee on AgNOR Quantification. RESULTS: AgNOR protein area (NORA) ≥5.28 μm2 was statistically associated with mitotic rate ≥5x10 high-power fields (hpfs) (P <.001) and presence of necrosis (P <.001); Ki-67 LI ≥9.69% was significantly associated with mitotic rate ≥5 × 10 hpfs (P <.001), size ≥5 cm (P =.033) and presence of necrosis (P <.001). Ki-67 LI and NORA strongly correlated. Preliminary Kaplan-Meier survival analysis showed that an increased value of NORA, Ki-67 LI, mitotic rate, tumor size and presence of necrosis had a negative influence on patient survival. Multivariate regression analysis showed that only NORA and Ki-67 LI were independent parameters in predicting the clinical outcome for patients with GISTs. Mitotic rate and necrosis remained as independent prognostic factors when NORA and Ki-67 LI were not allowed to enter in models. CONCLUSION: AgNOR protein quantity, as determined by image cytometry, and Ki-67 immunostaining seem to represent reliable predictive parameters in GISTs and are independent of mitotic rate, tumor dimension and necrosis.
Lingua originaleEnglish
Numero di pagine10
RivistaANALYTICAL AND QUANTITATIVE CYTOLOGY AND HISTOLOGY
Stato di pubblicazionePublished - 2003

All Science Journal Classification (ASJC) codes

  • Anatomy
  • Histology

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