Ki-67 labelling index is related to the risk classification and prognosis of gastrointestinal stromal tumours: a retrospective study

Gastrointestinal Stromal Tumour with Liver Metastasis Presenting as Gastric Cancer

Gastrointestinal stromal tumour (GIST) is a malignant tumour of the gastrointestinal lobe tissue, which mostly occurs in the gastrointestinal tract. Clinical manifestations can range from being benign to malignant. It mainly occurs in the gastric and small intestine. It may also develop in the colon, oesophagus, and bowel membranes, or outside the gastrointestinal tract and intestines. The pathological diagnosis of GIST depends on morphological measurements and immunohistochemistry. We report an interesting case in which the patient's gastroscopy indicated gastric malignant tumours, and the results of the contrast-enhanced computed tomography (CT) of the upper abdomen showed malignant stomach tumour accompanied by liver metastasis. After the patient knew about this diagnosis, she wanted to give up treatment. Finally, the gastric biopsy suggested positive CD34, CD117, DOG1, and Ki-67, which supported the diagnosis of GIST. We hope that, through this case, we could improve clinicians' understanding of GIST and improve its diagnosis and treatment.

Ki67 for evaluating the prognosis of gastrointestinal stromal tumors: A systematic review and meta‑analysis

Overexpression of Ki67 is observed in tumor cells, and it has been suggested to be a marker for cancer prognosis. However, the relationship between Ki67 expression and the risk of recurrence of gastrointestinal stromal tumors (GISTs) remains poorly defined. In the present study, a meta-analysis was used to examine the associations between Ki67 levels and GIST recurrence. Studies reporting GIST and Ki67 were found by searching Cochrane Library, PubMed and Embase until October 14, 2021. The Newcastle-Ottawa Scale (NOS) was used to verify the quality of the evidence. Totally, 1682 patient cases were included. The odds ratio (OR) estimates and 95% confidence interval (CI) for each publication were determined by a fixed-effects (Mantel-Haenszel) model. A total of 20 studies that fulfilled the inclusion criteria were finally included in the analysis. The average score of quality evaluation was 6.4 points according to NOS. It was found that Ki67 levels were significantly higher in the NIH L group compared with the NIH VL group (OR: 0.51; 95% CI: 0.26-0.99; P=0.04; P heterogeneity=0.44). There was also greater Ki67 overexpression in the NIH I group compared with the NIH L group (OR: 0.45, 95% CI: 0.31-0.65; P<0.0001; P heterogeneity=0.32), while Ki67 levels were greater in the NIH H group than in the NIH I group (OR: 0.20; 95% CI: 0.15-0.28; P<0.00001; P heterogeneity=0.56). In conclusion, Ki67 overexpression may be a useful marker of the risk of recurrent GIST transformation.